OBJECTIVE STRUCTURED CLINICAL SKILLS EXAMINATION

RESPIRATORY SYSTEM

ACADEMIC YEAR 2014/2015Bandung, Juni 29-30th 2015STATION : NEBULIZATIONStudents name :Students batch number :

Examiners name :Signature :

Date :

NoProceduresPerformance Scale

012

APreparations

1Greet the patient/parents and introduce yourself

BThe Implementation of procedure

2 Say Basmallah

3Check the nebulizer and read the manufacture manual and make sure it is clean

4Prepare -2 agonist (Salbutamol)

5Explain the procedure and the aim of nebulization

6Explain how to use the mouthpiece/facemask

7Wash hand (seven steps) and dry the hand

8Insert the flex tube that connect canister to the compressor in nebulizer

9Open canister and add medication to the reservoir. Close the canister and connect mouthpiece/facemask to the canister

10Connect nebulizer to electric source and turn on the nebulizer

11Confirm mist coming and flex tube

12Perform the nebulizer procedure to the patient for 10-15 minutes for jet nebulizer

13Monitor and document the procedure and response of the patient

14Clean and dry the canister, mouthpiece or face mask after each nebulization

15Say hamdallah

TOTAL SCORE

TOTAL PERCENTAGE SCORE

ACTUAL MARKPass/Fail

GLOBAL RATINGPass/Fail

CONCLUSIONPass/Fail

Note : 0 : If the student does not do the step 1 : If the student does do the step unsatisfactory

2 : If the student does do the step satisfactory

MAXIMUM SCORE : 16PERFOMANCE SCALE = TOTAL SCORE X 100%

16Score 80% : PASS

Score < 80% : FAIL