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INITIATION OF O2 THERAPY VIA NASAL CANNULA / SIMPLE MASK / WITH HUMIDIFIER

Student Name: __________________________________________  

PROCEDURE

Satisfactory

Unsatisfactory

5.

Verifies physician’s order in the patient’s chart

6.

Assembles equipment and checks its operation

a.

PPE

b.

Oxygen source

c.

Flow meter

d.

Oxygen cannula

e.

Simple O2 mask

f.

Bubble humidifier

7.

Introduces self to patient, verifies the patient’s identity, identifies the patient’s learning needs, and explains the procedure in terms the patient/family can understand

8.

Washes hands using the appropriate hand-hygiene procedure and initiates standard and/or transmission based precautions

9.

Plugs the flow meter into the oxygen source, attaches bubble humidifier to the flow meter and attaches nasal cannula to humidifier (attaches label with liter flow noted on the humidifiers, if this option is used)

10.

Adjusts flow meter to the ordered flow rate

11.

Checks operation of bubble humidifier and safety pop-off by pinching nasal cannula tubing until the pop-off is activated then releasing

12.

Places prongs of nasal cannula in patient's nacres and adjusts cannula to ensure a proper fit, avoiding pressure on the facial tissue

13.

Educates the patient in regards to oxygen therapy and the associated fire hazards

14.

Places the "no smoking" sign in a visible place at eye level.

15.

Correctly removes and disposes of PPE and washes hands

16.

Ensures the safety and comfort of the patient before leaving patient's room

17.

Records relevant data in patient chart and appropriate departmental records, and communicates pertinent  information regarding patient’s clinical status to appropriate members of the heath care team

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