Page 260 - Orthopedic Casts and Splints2

Performance Measures GO NO GO

1. Received the order from the physician (reviewed if in writing) —— ——
2. Identified yourself to patient. —— ——
3. Explained the procedure to the patient. —— ——

4. Inspected patient's upper extremities —— ——
5. Checked patient's capillary refill. —— ——

6. Gathered equipment. —— ——
7. Assembled materials —— ——

8. Prepared stockinette. —— ——
9. Prepared plaster reinforcement splint for the posterior aspect of the cast. —— ——

10. Placed cotton between toes to absorb moisture. —— ——
11. Applied stockinette to patient's injured leg. —— ——
12. Measured patient's injured ankle w/ goniometer. —— ——

13. Applied felt to injured ankle/leg. —— ——
14. Prepared casting materials. —— ——

15. Placed fiberglass casting/ examination gloves on hands. —— ——
16. Opened fiberglass casting package. —— ——
17. Opened packages of plaster rolls. —— ——

18. Applied 1st plaster or fiberglass roll. —— ——
19. Laminated the casting material. —— ——

20. Applied reinforcement splint to posterior aspect of cast. —— ——
21. Applied 2nd plaster or fiberglass roll. —— ——

22. Molded the cast material to the lower leg. —— ——
23. Checked alignment of injured wrist with goniometer. —— ——

24. Checked cast dimensions. —— ——
25. Applied 3rd plaster roll. —— ——
26. Cleaned plaster resin off patient's skin using a damp wash cloth, towel or —— ——
alcohol pad.
27. Applied cast shoe. —— ——

28. Administered crutch ambulation instruction. —— ——
29. Gave patient verbal and written instructions on cast care. —— ——

30. Annotated the procedure applied to patient in medical record or SF 513. —— ——
31. Escorted patient or direct family to front desk for follow-up appointment. —— ——

257