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according to agency Adjust bed agency policy alcohol swab ampule Assist patient bath blanket bedpan cannula Cleanse comfortable height comfortable position Comments Recommended Technique computer record cotton ball cuff Date Instructor's Signature Date Nursing Procedure dominant hand E S NP E S NP Comments EH Pass enema Excels Explain procedure Fail Student's Signature feeding fingers Flex flow sheet fold Foley Catheter Gather equipment Gather supplies gloves and wash heparin hydrogen peroxide inches injection Insert needle LJ Fail Student's medication Kardex Needs Practice LJ nondominant hand Nursing Procedure 57-1 optional Pass LJ Fail pillow pillowcase Place Practice CH Practice LJ Pass prior to putting procedure to patient pulse putting on gloves Recommended Technique E S Remove gloves Rescue Breathing rinse saline Satisfactory NP sterile gloves sternum syringe Technique E S Technique E S NP top sheet towel tracheostomy tubing Tuck urine vial Wash hands prior Waterproof pad