Arterial Blood Gas Procurement Evaluation Rubric (2022):
Arterial Blood Gas Procurement
Exemplary Accomplished
LEVEL
❑ Confirms physician’s
order and
CHECKS ORDER & ❑ Identifies
CHART contraindications
present in patient’s chart.
Maintains ideal infection
control. This includes washing
INFECTION hands, using appropriate PPE
CONTROL and maintaining aseptic
technique throughout the ABG
procedure.
Gathers all required Retrieves missing supplies on
GATHERS supplies for the ABG no more than one occasion
SUPPLIES procedure. prior to starting the ABG
procedure.
Dressed professionally. Identifies the patient, obtains

Shows initiative and positive consent and completes all but
attitude. one of the following:
S ▪ Identifies self and dept.
PROFESSIONALISM Communicates effectively with ▪ Identifies self and dept.
patient: U ▪ Explains procedure to patient
▪ Explains procedure to patient
AND C ▪ Answers questions appropriately
▪ Identifies self and dept. ▪ Answers questions
PATIENT ▪ Identifies the patient appropriately C
INTERACTION ▪ Explains procedure to patient E
▪ Obtains consent from pt. S
▪ Answers questions S
appropriately F
Confirms steady state Confirms steady state U Does NOT confirm steady state
conditions and notes HR, conditions and notes all but L conditions, or does NOT note two or
PATIENT STATUS RR, SpO2, and current oxygen one of the following: HR, RR,
therapy and/or specific FiO2. SpO2, and current oxygen  and current oxygen therapy and/or
therapy and/or specific FiO2.
Correctly performs the
CONFIRMS Modified Allen’s Test ensuring
the hand stays blanched until
COLLATERAL the Ulnar artery is released.
CIRCULATION Confirms refill time is less than
10 s.
Completes all steps of the Completes all steps of the
PROCURES ABG ABG procedure smoothly, ABG procedure with some
without any hesitation or hesitation and/or mistakes that
ACCORDING TO mistakes. are self-corrected in a timely
PROCEDURE fashion and cause no harm to
the patient.
Places ABG sample in a
biohazard bag. All sharps and
BIOHAZARD & biohazardous material disposed
SAFETY of properly. Sharps handled
properly
Sample label includes all of Sample label is missing one
the following: of the following
• Date and Time of draw • Date and Time of draw
in 24h notation in 24h notation
• Sample Type • Sample Type
• Patient Name and ID# • Patient Name and ID#
ABG LABEL • Oxygen Therapy or • Oxygen Therapy or
specific FiO2 or R/A if specific FiO2 or R/A if
no Oxygen Therapy no Oxygen Therapy
• Clinician’s Name and • Clinician’s Name and
designation designation
PASS/NOT PASS
Peer Evaluation Conducted by: ________________ for: __________________ Date:___________
Developing Comments
REDO REDO
❑ Does not check the physician’s
order or unable to identify
contraindications in patient’s
chart.
Break of infection control
compromising safety
Retrieves missing supplies on more .
than one occasion prior to starting the
ABG procedure, or is missing supplies
and has started the insertion procedure.
Does not identify the patient, or
obtains consent, or misses at least
two of the following:
more of the following: HR, RR, SpO2,
specific FiO2.
Does not perform the Modified Allen’s
Test, or incorrectly performs the
Modified Allen’s Test. (e.g. Hand does
not remain blanched when opened,
wrong artery released.)
Is unable to complete the steps of the
ABG procedure or makes a mistake
that causes harm to the patient (.
Improper redirect, excessive blood
loss…)
ABG sample not placed in biohazard
bag, or does not disposes of
biohazardous waste or sharps, OR
demonstrates unsafe needle practice
Sample label is missing two or more of
the following:
• Date and Time of draw in 24h
notation
• Sample Type
• Patient Name and ID#
• Oxygen Therapy or specific
FiO2 or R/A if no Oxygen
Therapy
• Clinician’s Name and
designation
Note: Any section scoring in the above columns
will require a REDO for the entire competency.