INSTITUTE OF CLINICAL LABORATORY SCIENCES

SILLIMAN UNIVERSITY

PERFORMANCE RUBRICS FOR 3rd PRACTICAL EXAM IN MT 12 (PRINCIPLES OF MEDICAL LABORATORY SCIENCE II )

LABORATORY SECTION:_______________ DATE:__________________

INSTRUCTION: Evaluate the student’s laboratory performance on a scale from 0 to 3 according to the different parameters listed below. Write your comments or remarks at the back of this page when appropriate.

VENIPUNCTURE (EVACUATED TUBE SYSTEM)

GENERAL PROCEDURES
1. Assemble all materials needed
2. Disinfects the working area prior to work
3. Materials are complete and wears complete PPE (lab gown, mask, gloves)
4. Identify the patient properly and correctly
5. Choose an appropriate site for collection and applies the tourniquet correctly at 3-4 inches above the site.
6. Palpates the vein using forefinger.
7. Removes tourniquet before disinfecting the site of collection.
8. Disinfects the site of collection in a correct manner using cotton with 70% alcohol.
9. Allows the area to totally dry.
10. Prepares the equipment by attaching the mullti-sample needle to holder and makes sure it is tightly attached.
11. Reapplies the tourniquet 3-4 inches above the site of collection.
12. Removes the needle cap using one hand only.
13. Inserts the needle between 15-30 degrees angle from the surface with the bevel side up.
14. Anchors the syringe/holder properly.
15. Chooses the appropriate evacuated tube for the test instructed.
16. Pushes the tube immediately as soon as the needle is inserted to the vein.
17. Collects correct amount of blood as instructed.
18. Removes the tube and tourniquet first before removing the needle.
19. Inverts the tube properly with the correct number of inversions (if needed).
20. Applies bandage on the site and instructs patient to apply pressure for 5 minutes.
21. Fishes out the cap needle using one hand and presses on a hard surface.
22. Removes needle and discards immediately to sharps container.
23. Labels the tube correctly with correct details (patient’s full name, DOB, age/sex, DOC, TOC, initials of phlebotomist).
24. Thanks the patient for cooperating during the procedure.
25. Discards all wastes into appropriate containers.
26. Disinfects working area after procedure and before leaving the room.
NUMBER OF CHANCES
TOTAL SCORE
LEGEND:
[3] PROFICIENT (always done within expectations)
[2] DEVELOPING (always done with some inconsistencies but still within expectations) ________________________________
[1] BEGINNING (always done with many inconsistencies and fails expectations) TEACHER’S SIGNATURE
[0] POOR (Did not perform)

COMMENTS