PERFORMANCE CHECKLIST

Caring for Jackson-Pratt Drain

LEVEL III – 2ND Semester
NCM 104

NAME: _________________________________ DATE: ________________________

YR/SEC ____________________________________ GRADE: _______________________

Equipments:
 Graduated container for measuring drainage

 Clean disposable gloves

 Alcohol pad

 Cleansing solution, Normal saline

 Sterile gauze pads

 Skin-protectant wipes

 Personal protective equipment,mask.

PROCEDURE PERFORMED REMARKS

Jackson-Pratt Drain YES NO

Assessment

Patency, current dressing, excess drainage,

appearance of incision for approximation of
wound edges, color and surrounding area and
signs of dehiscence.
Note the healing process and characteristic of
drainage.
Assess the surrounding skin color, temperature,
edema, ecchymosis or maceration
Procedure

1. Review the physician’s order for drain and

site care or nursing plan of care related to
drain care
2. Identify the patient

3. Administer appropriate analgesic

medication before wound care dressing
change.
4. Perform hand hygiene

5. Provide privacy. Position patient in a

comfortable position
6. Put on gloves; Put on mask if indicated.

7. Place the graduated collection container

under the outlet valve of the drain.
Without contaminating the outlet valve,
pull the cap off.

667 F.T. Dalupan Sr. St., Sampaloc, Manila Philippines

www.marychilescollge.edu.ph / marychilescollege@gmail.com
Tel. 711 - 4233, 735-5341 to 45
8. Empty the chamber’s contents completely
into the container. Use the alcohol pad to
clean the chamber’s spout and cap.
9. Fully compress the chamber with one
hand and replace the plug with your other
hand.
10. Check the potency of the equipments.
Make sure the tubing’s is free from twist
and kinks.
11. Secure the Jackson-Pratt drain to the
patient’s gown below the wound with the
safety pin, making sure that there is no
tension on the tubing.
12. Carefully measure and record the
character, color, and amount of the
drainage. Discard according to facility
policy.
13. if the drain site has a dressing, redness
the site.
14. If drain site is open to air, observe the
sutures that secure the drain to the skin.
Look signs of pulling, tearing, swelling, or
infection of the surrounding skin.
15. Gently clean the sutures with the gauze
pad soaked in a normal saline. Dry with a
new gauze pad. Apply skin protectant to
the surrounding skin if needed.
16. Remove gloves and all remaining
equipment, place the patient in a position
of comfort, wide side rails up and bed in
the lowest position, perform hand
hygiene.
Taylor’s clinical nursing skills
JCA…

RLE
SKILLSLABORATORY
CRITERIA FOR GRADING

Qualitative Grade Quantitative Grade Criteria

The student performs the competencies in a very

Excellent (E) 90 % & above consistent and independent manner with very minimal
guidance & supervision

The student performs the competencies in a consistent

Very Satisfactory (VS) 85 % and independent manner but requires moderate guidance
and supervision

The student performs the competencies in a consistent

Satisfactory (S) 80 % and independent manner with frequent guidance and
supervision

The student performs the competencies with errors even

Needs Improvement (NI) 75 %
with frequent guidance & supervision

Poor (P) 74 & below The student does not perform the competencies even

667 F.T. Dalupan Sr. St., Sampaloc, Manila Philippines

www.marychilescollge.edu.ph / marychilescollege@gmail.com
Tel. 711 - 4233, 735-5341 to 45
 under close supervision and guidance

____________________________ ______________________________________

Signature of students Signature of Clinical instructor

667 F.T. Dalupan Sr. St., Sampaloc, Manila Philippines

www.marychilescollge.edu.ph / marychilescollege@gmail.com
Tel. 711 - 4233, 735-5341 to 45