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
Related Medication Management Checklists
- Medication Storage & Handling - FREE Download
- Controlled Substance Count - FREE Download
- Medication Reconciliation - FREE Download
- IV Admixture Preparation - FREE Download
- Medication Administration Safety Checklist - FREE Download
- Medication Reconciliation at Admission Checklist - FREE Download
- Medication Administration Safety Checklist - FREE Download
- Pediatric Weight-Based Medication Dosing Checklist - FREE Download
- Anticoagulation Therapy Monitoring Checklist - FREE Download
- Chemotherapy Administration Safety Checklist - FREE Download
Why Use This Epidural/PCA Pump Assessment Checklist?
This epidural/pca pump assessment checklist helps healthcare teams maintain compliance and operational excellence. Designed for nurse professionals, this checklist covers 32 critical inspection points across 7 sections. Recommended frequency: every 4 hours / per protocol.
Ensures compliance with ASPMN Guidelines, ISMP Safe Practices, Hospital PCA Policy. Regulatory-aligned for audit readiness and inspection documentation.
Frequently Asked Questions
What does the Epidural/PCA Pump Assessment Checklist cover?
This checklist covers 32 inspection items across 7 sections: Pump Verification, Site Assessment, Patient Assessment, Side Effect Monitoring, Pre-Assessment Information, Infection Prevention & Control, Patient Safety & Identification. It is designed for healthcare operations and compliance.
How often should this checklist be completed?
This checklist should be completed every 4 hours / per protocol. Each completion takes approximately 10-15 minutes.
Who should use this Epidural/PCA Pump Assessment Checklist?
This checklist is designed for Nurse professionals in the healthcare industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.
Can I download this checklist as a PDF?
Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.