Subcutaneous Injection
Top Tips:
- Practice this skill and understand the differences between subcutaneous and intramuscular injections.
- Carefully read the prescription.
- Bring a sharps bin to the patient. If forgotten, use the provided tray to transport sharps safely.
Common Mistakes:
- Using insulin syringe to administer insulin at a 45-degree angle instead of the correct technique 90 – degree.
- Failing to properly check patient identification.
- Lacking knowledge of the differences between intramuscular and subcutaneous injections.
- Not preparing the skin before administration.
- Incorrect technique for subcutaneous injection.
- Administering the wrong medication dose.
- Unsafe handling of sharps.
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Peak Expiratory Flow Rate (PEFR)
Top Tips:
- Practice giving clear instructions to ensure patient understanding.
- Accurately document all three readings, recording the highest value on the nursing documentation.
Common Mistakes:
- Failing to provide complete instructions for the procedure.
- Incorrectly documenting or omitting the highest of the three readings.
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Midstream Specimen of Urine (MSU) & Urinalysis
Top Tips:
- Rehearse instructions for obtaining a midstream urine sample.
- Familiarize yourself with the procedure and the required equipment.
- Use appropriate personal protective equipment (PPE).
- Read reagent strips correctly, following the timing indicated on the bottle.
- Dispose of the sample and equipment properly.
- Educate patients based on the results obtained.
Common Mistakes:
- Failing to instruct the patient on proper cleansing before specimen collection.
- Not checking the expiry date or condition of reagent strips.
- Poor hand hygiene technique.
- Not using PPE when handling bodily fluids.
- Contaminating the reagent strip by incorrect handling.
- Failing to immerse and remove the strip correctly.
- Incorrect timing when reading results.
- Inaccurate documentation of findings.
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Intramuscular Injection (IM)
Top Tips:
- Understand the differences between subcutaneous and intramuscular injections.
- Carefully read the prescription.
- Always bring a sharps bin; if forgotten, use the tray provided.
Common Mistakes:
- Failing to check the sterility and integrity of equipment.
- Incorrectly recording administration (missing date/signature).
- Using the wrong needle to draw medication.
- Poor hand hygiene.
- Not using a sharps bin or tray to transport equipment.
- Incorrect injection technique.
- Unsafe sharps disposal.
- Not fully verbalizing prescription checks.
- Failing to demonstrate the safe scoop method for drawing medication.
Fluid Balance (FB)
Top Tips:
- Read the summary carefully to ensure accurate documentation.
- Use the calculator for accuracy.
- Utilize blank paper as needed for calculations.
Common Mistakes:
- Incomplete fluid balance charts.
- Incorrect recording of input, output, or total calculations.
- Failing to establish the patient’s fluid balance.
- Missing signature and printed name.
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Catheter Specimen of Urine (CSU)
Top Tips:
- Remove the clamp if used.
- Use a non-touch technique.
- Wear PPE throughout the procedure.
Common Mistakes:
- Running out of time during the assessment.
- Forgetting to remove the clamp.
- Taking the sample from the wrong port (e.g., balloon inflation port instead of sampling port).
- Not disinfecting the sampling port before collection.
Aseptic Non-Touch Technique (ANTT)
Top Tips:
- If contamination occurs, verbalize the mistake and corrective action.
- Follow proper hand hygiene at all necessary points.
- Work as a lone practitioner and maintain sterility.
Common Mistakes:
- Failing to check sterility and integrity of equipment.
- Running out of time before completing the procedure.
- Poor hand hygiene, including after opening packaging.
- Not wearing PPE.
- Contaminating the sterile field.
- Using improper techniques (e.g., reusing a swab for wound cleaning).
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Administration of Inhaled Medication (AIM)
Top Tips:
- Familiarize yourself with the inhaler device.
- Carefully read the prescription.
- Develop a step-by-step approach for accuracy.
- Keep explanations concise.
Common Mistakes:
- Not waiting the correct time between doses.
- Skipping essential safety checks before administration.
- Incomplete documentation (missing date/signature).
- Poor hand hygiene.
- Running out of time due to excessive patient education.
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APIE: Evaluation
Top Tips:
- Read all statements carefully before responding.
- Ensure transfer of care/referral letters provide a full and accurate patient history.
- Document allergies and reactions.
- Consider the patient’s progress, condition, and care needs.
Common Mistakes:
- Omitting allergy documentation.
- Failing to include essential details such as name, date, and reason for transfer.
- Providing an incorrect diagnosis or referral reason.
- Excluding relevant spiritual or family care needs.
- Not identifying risks related to the patient’s deterioration.
- Referring to irrelevant care interventions.
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APIE: Implementation
Top Tips:
- Practice reading Medication Administration Records (MAR) aloud.
- Develop a strategy to identify medications the patient is allergic to.
- Check the timing of the last analgesia dose.
- Explain the purpose of each medication.
- Check pulse rate before administering Digoxin.
- Do not sign the MAR until the examiner confirms medication intake.
- Ensure timely and accurate documentation.
Common Mistakes:
- Administering medication at the wrong time or despite allergies.
- Incomplete or inaccurate documentation.
- Lacking knowledge of prescribed medications.
- Not systematically reviewing the MAR.
- Failing to check prescription validity (dose, route, prescriber’s signature).
- Signing the MAR before medication is taken.
- Incorrect dosage administration.
- Running out of time.
- Skipping patient identification checks.
- Not administering any medication within the given time.