E. Id Intradermal

Name: __________________________________ Yr.& Sec. __________Date: _________ C.I.
_____________
INTRADERMAL (ID) RUBRICS
CRITERIA
4 3 2 1
Proficient Approachin Developing Beginning Rating

g
proficiency
PROCEDURE Independently Performs Performs Performs

performs all skills with skills with skills with
skills fluently assistance of assistance
and without assistance of faculty 3 - 4 of faculty
difficulty. faculty 1 - 2 times during greater than
times during simulation 4 times
simulation. during
simulation
STEPS
1.Check accuracy and

completeness of each medication
administration record (MAR) with
prescriber’s medication order.
Check patient’s name and
medication name, dosage, and route
and time for administration.
2. Check date of expiration for

medication.
3. Perform hand hygiene.

Aseptically prepare correct
medication dose from ampule or
vial. Check label of medication with
MAR two times while preparing
medication.
4. Close room curtain or door.
5. Introduce self and Identify patient

using two identifiers (e.g., name and
birth date or name and account
number) according to facility policy.
Compare identifiers with information
on patient’s MAR or medical record.
6. Compare name of medication on

label with MAR one more time at
patient’s bedside
7. Explain steps of procedure and

tell patient that injection will cause a
slight burning or sting.
8. Apply clean gloves. NOTE: If
patient has latex allergy, use latex-
free gloves.
9. Select appropriate injection site.

Inspect skin surface over sites for
bruises, inflammation, or edema.
*Note lesions or discolorations of

skin. If possible, select site three to
four finger widths below antecubital
space and a hand width above wrist.
10. Help patient to comfortable

position:
*Have patient extend elbow and

support it and forearm on flat
surface.
11. Clean site with an antiseptic

swab. *Apply swab at center of site
and rotate outward in circular
direction for approximately 5 cm (2
inches).
12. Hold swab or gauze between

third and fourth fingers of non-
dominant hand.
13. Remove needle cap or sheath

from needle by pulling it straight off.
14. Hold syringe between thumb

and forefinger of dominant hand
*Hold bevel of needle pointing up.
15. With non-dominant hand stretch

skin over site with forefinger or
thumb.
16. With needle almost against

patient’s skin, insert it slowly with
bevel up at a 5- to 15-degree angle
until resistance is felt. Advance it
through epidermis to approximately
3 mm (1 8 inch) below skin surface.
You will see needle tip through skin.
17. Inject medication slowly.

Normally you feel resistance. If not,
needle is too deep; remove and
begin again. Non-dominant hand
can stabilize needle during the
injection.
18. While injecting medication,

notice that small bleb approximately
6 mm (1 4 inch) in diameter
(resembling mosquito bite) appears
on surface of skin. Instruct patient
that this is a normal finding.
19. Withdraw the needle quickly at

the same angle at which it was
inserted.
• Do not massage the area.
20. Help patient to comfortable

position
21. Discard uncapped needle or

needle enclosed in safety shield and
attached syringe into puncture-proof
and leak-proof receptacle.
22. Remove gloves and perform

hand hygiene
23.Observe patient’s response to

medication at times that correlate
with onset, peak, and duration of
medication.
24.Use skin pencil and draw circle

around perimeter of injection site.
Read site within appropriate amount
of time, designated by type of
medication or skin test administered.
25. Chart medication dose, route,

site, time, and date given on MAR
immediately after giving medication .
TOTAL POINTS: 100
____________________________________________ ____________________________________________
Signature over Printed name of the Student Signature over Printed name of the Clinical Instructor
Prepared:
Marie Christine N. Mercado, RN, MAN, Ed.D
Level II – RLE Coordinator
Noted:
Jill Marie C. Hermogenes, RN, MAN, Ed.D Approved:
Assistant Dean Michelle B. Yu, RN, MAN, DM
Dean

E. Id Intradermal

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Name: __________________________________ Yr.& Sec. __________Date: _________ C.I.

INTRADERMAL (ID) RUBRICS

Proficient Approachin Developing Beginning Rating

PROCEDURE Independently Performs Performs Performs

1.Check accuracy and

2. Check date of expiration for

3. Perform hand hygiene.

4. Close room curtain or door.

5. Introduce self and Identify patient

6. Compare name of medication on

7. Explain steps of procedure and

9. Select appropriate injection site.

*Note lesions or discolorations of

10. Help patient to comfortable

*Have patient extend elbow and

11. Clean site with an antiseptic

12. Hold swab or gauze between

13. Remove needle cap or sheath

14. Hold syringe between thumb

*Hold bevel of needle pointing up.

15. With non-dominant hand stretch

16. With needle almost against

17. Inject medication slowly.

18. While injecting medication,

19. Withdraw the needle quickly at

• Do not massage the area.

20. Help patient to comfortable

21. Discard uncapped needle or

22. Remove gloves and perform

23.Observe patient’s response to

24.Use skin pencil and draw circle

25. Chart medication dose, route,

TOTAL POINTS: 100

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Name: ________________________ Yr.& Sec. Date: _ C.I.