Name date

CHECKLIST FOR BIOMEDICAL WASTE MANAGEMENT

S.NO STEPS/TASKS FIRST SECOND THIRD FOURTH FIFTH
. ASSESSMENT ASSESSMEN ASSESSMEN ASSESSMEN ASSESSMENT
T T T
1. Discard the placenta into a
leak proof container with a
plastic liner or as per the
waste management
guidelines.
2. Disposes medical waste in a
plastic liner.
3. Put the solid linen in a leak
proof container.
4. Places all reusable
instrumentsin a 0.5%
chlorine/hydrochlorite for 10
minutes.
5. Decontaminates the syringe
and needle by flushing them
three times with 0.5%
chlorine solution and
disposes of the needles and
syringe in a puncture
resistant container, without
removing , recapping or
breaking the needle.
6. If gloves are disposable,
immerse both gloves hands
in 0.5% chlorine solution,
remove gloves by inverting
and placing them in a
container with a plastic liner ,
if they are reusable ,
immerse them in a 0.5%
chlorine solution for at least
10 minutes.
7. Perform hand hygiene after
 removing gloves.
8. Washes hand with running
water and soap for 20
seconds and dries with an
individual clean towel or rub
hands with alcohol based
solution

INSTRUCTIONS :

Scoring is to be given as :

Performed well -2 perfromed average -1 did not performed -0

MAXIMUM SCORE :8

SCORE OBTAINED :

REMARKS :

SIGNATURE OF STUDENT/FACULTY SIGNATURE OF SUPERVISOR

Name date
CHECKLIST FOR OXYGEN ADMINISTRATION
S.NO. STEPS/TASKS FIRST SECOND THIRD FOURTH FIFTH
ASSESSMEN ASSESSMENT ASSESSMEN ASSESSMENT ASSESSMENT
T T
1. Connect the oxygen
flowmeter to oxygen and
supply source
2. Apply the adapter for
tubing.
3. Connect nasal cannula
tubing to flowmeter.
4. Set oxygen flow rate .

5. Evaluate patient
response to oxygen
therapy including airway
response and respiratory
rate
6. Assess the patient to
comfortable position

INSTRUCTIONS :

Scoring is to be given as :

Performed well -2 perfromed average -1 did not performed -0

MAXIMUM SCORE :6

SCORE OBTAINED :

REMARKS :

SIGNATURE OF STUDENT/FACULTY SIGNATURE OF SUPERVISOR

Name date

CHECKLIST FOR BLOOD TRANSFUSION

S.NO. STEPS/TASKS FIRST SECOND THIRD FOURTH FIFTH
ASSESSMENT ASSESSMENT ASSESSMENT ASSESSMENT ASSESSMENT
1. Ask the patient if he/she
allergic to any
medication, or had
transfusion or
transfusion allergy in the
past.
2. Start the iv with 18 to 19
gauze cathether. If it is
stopped then open the
cannula flow with
normal saline solution.
3. Obtain blood product
from blood bank.
4. Identify the blood
group , patients name ,
expiry.
5. Take baseline sets of
vital signs before
beginning the
procedure.
6. Start administration
slowly and check for
atleast 5 to 10 minutes ,
if there is any reaction.
7. Ongoing monitoring is
crucial throughout the
entire position.
8. Blood transfusion should
be done within a time
period of 3 to 4 hours.
9. Throughout whole
process maintain and
check the temprature of
the surrounding .
10. After transfusion clamp
of the blood set and
start the normal iv
 infusion.
11. Record the blood
administration as per
rule of the agency.
12. Discard all the
components as per there
respective bmw waste
management.

INSTRUCTIONS :

Scoring is to be given as :

Performed well -2 perfromed average -1 did not performed -0

MAXIMUM SCORE :12

SCORE OBTAINED :

REMARKS :

SIGNATURE OF STUDENT/FACULTY SIGNATURE OF SUPERVISOR