NSG 122 Nursing Skill Competency: Administering Oxygen Peer Check-Off Peer must check that each section was completed by checking the box yes or no Name: ________________________________ Date:____________________ Respiratory Assessment Verify order Explains different reasons a patient might need oxygen administered Perform skill over riders -Provide privacy -Hand hygiene -Introduce self & explain procedure - Gather equipment Identifies patient with two identifiers Performs initial respiratory assessment (including oximetry) Assesses current Oxygen use level Incentive Spirometry (IS) Explains the purpose for IS to the patient. Explains how to perform IS to the patient. (Detail: Hold IS upright, exhale completely, place lips around mouthpiece, slow deep breath, hold breath 1 seconds, and exhale normally) Verbalizes which patients who would most benefit from IS Instructs the patient to use independently and how often Oxygen Delivery Devices Nasal Cannula Identifies nasal cannula Verbalizes O2 flow rate (LPM) for nasal cannula Verbalizes approximate FiO2 level for nasal cannula Simple Face Mask Identifies simple face mask Verbalizes O2 flow rate (LPM) for simple face mask Verbalizes approximate FiO2 level for simple face mask Non-Rebreather Mask Identifies a Non-rebreather mask Verbalizes O2 Flow rate (LPM) for Non-Rebreather Mask Verbalizes approximate FiO2 level for Non-Rebreather mask Yes No Venturi Mask Identifies a Venturi Mask Verbalizes O2 flow rate (LPM) for Venturi mask Verbalizes approximate FiO2 level for Venturi Mask Additional Oxygenation Needs Verbalizes when to use humidity with oxygen delivery Verbalizes when a nebulizer might be needed. Completed: _________ Peer name: _____________________________________ Peer Signature: _____________________________________ Date: _________________ Comments:
