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Implanon Insertion Revised Checklist

This document is a checklist for observing and evaluating a provider's skills in inserting an Implanon implant. It lists 18 specific tasks involved in pre-insertion assessment, insertion, and post-insertion care. For each task, the observer rates the provider's performance as 2 (competently performed), 1 (needs improvement), or 0 (step omitted). Critical steps are marked in bold. To be considered competent, the provider must score a 2 on all steps and perform them in the correct sequence. The form is used to assess individual providers and is filled out by the trainer observing the procedure.

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Derese Gosa
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63 views

Implanon Insertion Revised Checklist

This document is a checklist for observing and evaluating a provider's skills in inserting an Implanon implant. It lists 18 specific tasks involved in pre-insertion assessment, insertion, and post-insertion care. For each task, the observer rates the provider's performance as 2 (competently performed), 1 (needs improvement), or 0 (step omitted). Critical steps are marked in bold. To be considered competent, the provider must score a 2 on all steps and perform them in the correct sequence. The form is used to assess individual providers and is filled out by the trainer observing the procedure.

Uploaded by

Derese Gosa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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IMPLANON IMPLANT INSERTION

CLINICAL SKILL COMPETENCY ASSESSMENT CHECKLIST

Instructions:
This observation checklist is to be used by trainer/s to observe the provider Implanon insertion
skills during post training follow-up or clinical monitoring and coaching visit. The trainer marks
one of the following scores to represent the performance level of each Implanon insertion
task/step observed:

Use the following rating scale:


2 = competently performed (step performed correctly)
1 = Needs improvement (step performed partially or incorrectly)
0 = Step omitted (step not done)
The provider must perform satisfactorily and in the correct sequence all the tasks and the steps of
the procedure, to be considered complying with standard steps of counseling skill. Steps that
appear with bold font are considered as critical steps. If the trainee scores less than 2 in any step,
he/she needs improvement.
The trainer fills out one form for each trainee/provider observed.

Provider Name ________________________ Provider Code ____________________

Name of Health Facility___________________ Facility Code:______________________


IMPLANON CLINICAL SKILLS
TASK/STEPS Rating scale
PRE-INSERTION MEDICAL ASSESSMENT
1. Confirms client wants Implanon inserted.
2. Reviews with client information in her record and ensures that she has
been counseled appropriately for Implanon.
PRE-INSERTION TASKS
3. Marks insertion site
4. Washes hands thoroughly with soap and water and dries with clean, dry
towel or air dry
INSERTION TASKS
5. Cleans insertion site 2 times with antiseptic solution
6. Anaesthetizes with 2 ml of 1% lidocaine applied just under the skin along
the insertion area:
 Raises a small wheal in skin entry,
 Advances needle about 5 cm, injects 1 ml of local anesthetic.
7. Removes sterile disposable Implanon applicator from blister and removes
needle shield using no-touch technique (Never touches the part of
cannula to be introduced to the body).
TASK/STEPS Rating scale

1
8. Visually verifies presence of implant inside metal part of the cannula.
9. Stretches skin around insertion site with thumb and index finger by placing
hand over insertion site, directed towards her/him. Alternatively,
stretches insertion site skin by slightly pulling with her/his thumb.
10. Inserts only the tip of cannula, slightly angled (~ 20°).
11. Releases skin and lowers applicator to horizontal position.
12. While lifting skin to form a tent, gently advances and inserts full length
of canula without using force. Keeps applicator parallel to skin surface.
13. Breaks seal of applicator and turns obturator 90°.
14. Fixes obturator with one hand against the arm and slowly pulls the
cannula out of the arm with other hand. Never pushes against the
obturator.
15. Removes the cannula, applies pressure on the opening site.
POSTINSERTION TASKS
16. Disposes cannula in safety box as any other sharps/needle
17. Disposes of waste materials
18. Gives post insertion instructions

Competency rating
Trainee/Provider is _______ (Competent/ Not Competent)
Trainer Name ___________ Trainer Code___________ Date________________

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