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INITIATION OF O2 THERAPY VIA PARTIAL AND NON-REBREATHING MASK

Student Name: __________________________________________  

PROCEDURE

Satisfactory

Unsatisfactory

1.

Verifies physician’s order in the patient’s chart

2.

Assembles equipment and checks its operation

g.

PPE

h.

Oxygen source

i.

Flow meter

j.

Partial rebreathing mask

k.

Non-rebreathing mask

l.

Bubble humidifier

18.

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

19.

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

5.

Plugs the flowmeter into the oxygen source, attaches bubble humidifier to the flowmeter, and attaches nonrebreathing mask to humidifier (attaches label with liter flow noted on the humidifier if this option is used)

6.

Checks operation of humidifier and safety pop-off by turning on the oxygen flow and then pinching the oxygen tubing until the pop-off is activated then releasing

7.

While the rebreathing bag is full, places the nonrebreathing mask or partial rebreathing mask on the patient's face and adjusts the straps for a proper fit;  avoiding too much pressure on the patient's facial tissue (Note: When using a partial rebreathing mask, remember to remove the appropriate valves)

8.

Ensures that the oxygen liter flow is sufficient so that the rebreathing bag remains completely inflated during the patient's inspiration

9.

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

10.

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

11.

Correctly removes and disposes of PPE and washes hands

12.

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

13.

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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