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JOSE RIZAL UNIVERSITY
College of Nursing and Health Sciences
Performance Checklist
Oro-Nasopharyngeal Suctioning
Name of Student: Pamintuan, Caryl Jia C.
Year/Section/Group No.: BSN 202
03/29/2023
Date: ___________
Grade: __________
Rate the student’s performance by checking the appropriate box using the following criteria:
5- Excellent
(Carries out procedure efficiently, systematically and independently/ Personality trait is observed
at all times)
4- Very Satisfactory (Carries out procedure efficiently and systematically, requires minimal guidance and supervision/
Personality trait is observed most of the time)
3- Satisfactory
(Carries out procedure efficiently and systematically, requires moderate guidance and
supervision/
Personality trait is observed sometimes)
2- Fair
(Carries out procedure with close guidance and supervision/ Personality trait is seldom
observed)
1- Poor
(Carries out procedure inefficiently and unsystematically/ Personality trait is never observed)
5
A. KNOWLEDGE
1. Assess patient’s respiratory function and patency of nostrils / nasal cavity
2.
Explain the procedure entails to the patient/S.O.
3.
Prepare necessary supplies and bring at bedside:
a. Suction apparatus
b. Sterile suction catheter with suction port
c. Sterile saline/sterile water
d. Sterile container
e. Sterile gloves
f. Clean towel
g. Stethoscope
Wash hands
4.
B. SKILLS
5. Properly position the patient:
a. For conscious patient
 Semi-fowler’s position with head turned to one side for oral
suctioning.
 Semi-fowler’s position with neck hyperextend for nasal
suctioning.
b. For unconscious patient
 Lateral position facing the nurse.
6. Place a towel on the pillow or under the patient’s chin.
7. Turn the suction “ON”: to the appropriate pressure if applicable.
8. Pour sterile water or NSS into sterile container.
9. Peel back the wrapper of the catheter until the adapter is exposed.
10. Pre-oxygenated patient with 100% oxygen for 1-2 minutes.
11.
Apply a sterile glove to your dominant hand and clean glove with non-dominant
hand. Remove the wrapped around the catheter with the non-dominant hand
(un-sterile hand). Coil the catheter around your dominant hand (sterile hand)
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To evaluate the patient’s breathing and
oxygenation.
To build trust and make the patient aware
of the procedure
To have the equipments easily accessible
and ready for the procedure.
To prevent the transmission of
microorganism that may lead to infection.
To promote comfort and help in effective
suctioning of secretion.
To support the head of the patient.
To get ready to the suctioning procedure.
To be prepared in the procedure.
To maintain the catheter sterile.
To help support the patient’s oxygen
while doing the procedure.
To prevent contamination and avoid
possible infection.
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12.
13.
14.
15.
16.
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19.
20.
21.
using fingers as you remove it from the wrapper.
Holding the sterile suction catheter with dominant hand, connect the distal end
of the catheter to the suction that is held with the non-dominant hand.
Approximate the distance between the patient’s nose to earlobe (for
nasopharyngeal) and mouth to earlobe (for oropharyngeal) then place thumb
and forefinger of dominant hand at that point.
Moisten the catheter tip with sterile solution. Apply suction with catheter tip in
the solution.
Suction:
 For nasopharyngeal suctioning, gently insert catheter into one
nostril. Guide the catheter medially along the floor of the nasal
cavity. Don not force the catheter. If one nostril is not patent, try the
other. Do not apply suction during insertion.
 For Oropharyngeal suctioning, gently insert the catheter into one
side of the mouth and slide the catheter to the oropharynx. Do not
apply suctioning during insertion.
Apply suction by occluding the suction control port with the thumb of nondominant hand. Gently rotate the catheter with the thumb and index finger of
the dominant hand as you withdraw it.
Flush the catheter with sterile solution by placing it in the solution and apply
suction.
If the patient is able, ask them do deep breathe and cough between suctions. If
suctioning needed, repeat step (from moistens the catheter tip).
When procedure is completed, turn “OFF” suction machine. Dispose gloves
and catheter properly. Wash your hands.
Offer oral hygiene. Place patient in comfortable position. Empty suction
collection bottle frequently.
Use auscultation to listen to the chest to assess the effectiveness of
suctioning. Record the time of suctioning, amount, consistency, color and odor
of secretions, and the patient’s response to the procedure. Empty suction
bottle at the end of every shift.
To avoid contamination that may lead to
unsuccessful procedure.
To know how long/much tube will enter
the oro and naropharyngeal.
To make the insertion easier and make it
less painful to the patient.
To ensure safety and effectiveness of the
procedure with no harm to the patient.
To help make the airway clear with no
harm to the patient.
To clear/clean the catheter.
To make sure that the patient’s airway is
clear.
To reduce the risk of respiratory infections
and other complications.
To make sure that the patient is free from
any infections.
To see if there are any improvements and
to let the next nurse know that the
procedure is done.
TOTAL
Total score / Total no of items x 60 + 40 = _____
Total Grade ________
Clinical Instructor’s Comments / Suggestions:
______________________________________________________________________________________________.
Students’ Comments / Suggestions:
_____________________________________________________________________________________________.
________________________________
Student’s name & signature
_________________________
C.I.’s name & signature