Name: ________________________________________________________ Date: ________________
Course: _______________________________________ _______ Grade:_______________
COMPETENCY CHECKLIST
ADMINISTERING INTRADERMAL INJECTION
Expected Outcome: The nurse will properly execute and administer intradermal medication to
the right patient observing the 14 Rights of Medication.
Rate the student as follows:
1 - Needs Practice 3 - Very Satisfactory
2 - Satisfactory 4 - Excellent
4 3 2 1
1. Verify doctor’s order
2. Calculate correct dosages
3. Practice hand hygiene
4. Prepare supplies and equipment
5. Practice 14 Rs of Medication (enumerate and explain)
6. Double check data on the medication card with the medicine to be prepared
7. Disinfect rubber cap of vial before inserting needle
8. Replace aspirating needle with sterile needle to be used for injection
9. Place all needed materials on medication tray
10. Introduce self
11. Identity patient using two patient identifiers
12. Verify for allergy
13. Explain procedure and answer questions appropriately
14. Provide patient privacy
15. Assist patient in comfortable position and identify injection sites
16. Disinfect injection site (use cotton balls with alcohol on a circular motion
from inner to outer movement)
17. Remove needle cap and expel air bubbles
18. Stretch the skin and insert needle, bevel up 10 – 15 degree angle.
19. Release the skin, anchor the barrel and inject the medication slowly to
make a small wheal
20. Wipe excess medication with dry cotton balls
21. Encircle the wheal with blue or black ballpen; and write the drug name and
due time
22. Aftercare
23. Documentation
TOTAL
Formula: Final Grade (in percentage) = total score divided by 92, multiply by 100.
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SIGNATURE ABOVE PRINTED NAME OF RATER
