Epidural/PCA Pump Assessment Checklist
Comprehensive epidural and PCA pump assessment including pump settings verification, patient assessment, and side effect monitoring.
- Industry: Healthcare
- Frequency: Every 4 hours / Per protocol
- Estimated Time: 10-15 minutes
- Role: Nurse
- Total Items: 32
- Compliance: ASPMN Guidelines, ISMP Safe Practices, Hospital PCA Policy
Pump Verification
Verify pump settings
- Medication and concentration correct?
- Settings match physician order?
- Lockout interval correct?
- Dose limits set appropriately?
- Pump locked and secure?
Site Assessment
Catheter/IV site
- Catheter/IV site intact?
- Dressing clean and intact?
- No leaking at site?
- Catheter/tubing secured?
Patient Assessment
Clinical assessment
- Pain level assessed and documented?
- Sedation level assessed (Pasero scale)?
- Respiratory rate documented?
- O2 saturation documented?
Side Effect Monitoring
Opioid side effects
- No excessive sedation?
- No respiratory depression?
- Nausea/vomiting assessed?
- Pruritus assessed?
- Motor function assessed (epidural)?
Pre-Assessment Information
Initial assessment documentation and patient/facility identification
- Assessor Name / Credentials
- Assessment Date
- Department / Unit
- Assessment Type (Routine/Annual/Complaint)
- Previous assessment findings reviewed?
Infection Prevention & Control
Verify infection control practices per CDC and Joint Commission standards
- Hand hygiene compliance observed?
- Appropriate PPE available and properly used?
- Isolation precautions properly implemented?
- Sharps containers available and not overfilled?
- High-touch surfaces properly disinfected?
Patient Safety & Identification
Verify patient safety protocols and identification procedures
- Two patient identifiers used before procedures?
- Fall risk assessment completed?
- Call light within patient reach?
- Bed in lowest position with brakes locked?
Related Healthcare Checklists
- Narcotic Count/Controlled Substance Verification Checklist
- High-Alert Medication Dispensing Checklist
- PCA Monitoring Checklist
- Medication Error Prevention Checklist
- Nursing Peer Review Checklist
- Patient Elopement Prevention Checklist
- Medical Device Incident Report Checklist
- Hospital-Acquired Condition Prevention Checklist