Procedural Safety Checklist



All procedures must be supervised by an appropriately credentialed resident or attending

Core Floor Procedures Requiring Credentialing

  • Arterial puncture (5)
  • Nasogastric tube placement (5)
  • Paracentesis (5)

After you finish, have supervisor review your performance and complete entry in your ABIM logbook.

  • Turn your slips into Sappherin Miranda in the medicine office

Off-service rotators may not be credentialed for procedures on Medicine, and cannot perform procedures unsupervised.

Pre-procedure Verification / Time Out

Perform prior to every procedure

Notify the patient's nurse and perform a time-out before starting.

Verify with patient

  • Name, DOB
  • Procedure and Site
  • Allergies
  • Laterality R/L

Verify with proceduralist

  • Consent completed
  • Labs reviewed
  • Imaging diagnostic reports show name, DOB, laterality
  • Pregnancy test negative
  • Implants, supplies present, and expiration dates checked

Nasogastric tube

Only non-styleted NG tubes may be used on Medicine floors

Diagnostic paracentesis

Consent patient (consent found in PatientWorks on Desktop). Major risks include:

  • Bleeding, infection, perforation (use ultrasound to avoid)

Supplies (Kit available on 9C, talk to nurse manager, or assemble the following:

  • Ultrasound with abdominal probe
  • Chucks
  • Sterile drapes (x3)
  • Pink bucket to gather supplies
  • 3-5 chlorapreps
  • Sterile gloves (get extra)
  • 4x4 gauze sponges
  • 1% Lidocaine without epi
  • 20G needle (medium) to draw up lido
  • 25G needle (small) for injecting lido
  • 5-12cc syringe for lidocaine
  • 18-22G (med-large) needle for tap
  • 30-60cc syringe for tap
  • extra syringes for transferring fluid
  • tegaderm

Laboratory tubes:

  • 2 lavender top tubes for cell count & diff
  • 2 yellow (urine) top tubes for gram stain/culture, LDH, protein, albumin
  • Blood culture bottles (more sensitive for organisms)
  • specimen bags to send tubes (tube to station 91)

Labs to Order (on ascitic fluid):

  • Cell count & diff
  • Gram stain & culture
  • Albumin (make sure there is a serum albumin from that day)
  • LDH
  • Protein

Central venous catheter