Respiratory Cloud Clinical Skills Library

Skills Assessment Report

Date:

Skill Assessment - Oxygen Blender

Notes
  • Shared interskill preparation structure retained from the existing library; clinical and procedure-specific content is supported by peer-reviewed literature.
  • Shared interskill follow-up structure retained from the existing library; follow facility policy, scope of practice, provider orders, and device instructions for use.
Step Pass Unsatisfactory
Knowledge
States Contraindications and Relative Contraindications of procedure.
Preparation
Clinical Standards for Procedures and Interventions.
Verifies the oxygen order or protocol, patient-specific oxygen-saturation target, required flow range, and intended patient interface.
Inspects the blender, high-pressure hoses, gas-specific connectors, outlet, flowmeter, alarm or bypass function, and service status; removes damaged or overdue equipment from use.
Connects medical air and oxygen to the correctly labeled gas-specific inlets and confirms both source pressures are within the manufacturer-specified operating range.
Connects a calibrated oxygen analyzer at the actual blender outlet or downstream point of delivery and allows the system to stabilize.
Implementation
Sets the prescribed fraction of inspired oxygen (FIO2) and total flow, using a flowmeter designed and oriented for the mixed gas and operating pressure.
Measures delivered FIO2 at the point of delivery and confirms agreement with the blender setting within the device and institutional tolerance before patient connection.
When permitted by the manufacturer and local policy, verifies the source-failure alarm or bypass one source at a time without interrupting patient care, then restores both sources.
Monitoring & Modifications
Continuously or intermittently monitors delivered FIO2, flow, alarm status, patient oxygen saturation, respiratory status, and clinical response as appropriate to acuity.
Investigates discrepancies by checking source pressure, hose and connection integrity, flowmeter orientation and calibration, downstream resistance, leaks, analyzer calibration, and blender function.
Reanalyzes delivered oxygen after any change in FIO2, flow, interface, circuit, source pressure, or equipment configuration.
Post-Intervention
Documents prescribed and measured FIO2, total flow, source and alarm verification, patient response, and any troubleshooting or equipment removal.
Post-Intervention Management Steps.
References

Summary Performance Evaluation

Evaluator

Student Signature

Printed Name:
Credentials:
Date:

Evaluator Signature

Printed Name:
Credentials:
Date:

Complete all required fields, assessment responses, and both signatures before creating the PDF.