Catanduanes State University
College of Health Sciences
DEPARTMENT OF NURSING
Virac, Catanduanes
NCM 103 RLE – Fundamentals of Nursing Practice
Name ____________________________Block _____ Group_____ Date ________
PERFORMANCE CHECKLIST – APPLYING SEQUENTIAL COMPRESSION
DEVICES
PURPOSES
• To promote venous return from the legs
• To decrease risk of deep venous thrombosis and/or PE
ASSESSMENT
Assess for baseline data:
• Cardiovascular status, including heart rate and rhythm, peripheral pulses, and capillary
refill
• Color and temperature of extremities
• Movement and sensation of feet and lower extremities and Homans’ sign
EQUIPMENT
• Measuring tape
• SCD, including disposable sleeves, air pump, and tubing
DIRECTIONS:Mark each step of the procedure following the rubric below denoting the
skill performance of the student. Total the scores and look for the equivalent grade on
the transmutation table. The Remark section is for suggestions that will help improve the
skills of students.
(3) – Skill performed with mastery using the recommended technique.
(2) – Skill performed using the recommended technique but without mastery.
(1) – Skill performed using some but not all of the recommended technique.
(0) – Skill not performed or missed
SCORE
STEPS 3 2 1 0 REMARKS
1. Prior to performing the procedure, introduce self and verify the
client’s identity using agency protocol. Explain to the client what
you are going to do, why it is necessary, and the procedure for
applying the sequential compression device.
2. Perform hand hygiene and observe other appropriate infection
prevention procedures.
3. Provide for client privacy and drape the client appropriately.
4. Prepare the client.
• Place the client in a dorsal recumbent or semi-Fowler’s position.
• Measure the client’s legs as recommended by the manufacturer
if a thigh-length sleeve is required.
5. Apply the sequential compression sleeves.
• Place a sleeve under each leg with the opening at the knee.
• Wrap the sleeve securely around the leg, securing the Velcro
tabs. Allow two fingers to fit between the leg and the sleeve.
6. Connect the sleeves to the control unit and adjust the pressure
as needed.
• Connect the tubing to the sleeves and control unit, ensuring that
arrows on the plug and the connector are in alignment and that
the tubing is not kinked or twisted.
• Turn on the control unit and adjust the alarms and pressures as
needed. The sleeve cooling control and alarm should be on;
ankle pressure is usually set at 35 to 55 mmHg.
7. Document the procedure.
• Record baseline assessment data and application of the SCD.
Note control unit settings.
• Assess and document skin integrity and neurovascular and
peripheral vascular status per agency policy while the SCD is in
place. Remove the unit and notify the primary care provider if the
client complains of numbness and tingling or leg pain.
Total
Equivalent Grade
___________________ _______________________________
Student’s Signature Name & Signature of Clinical Instructor