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Name: __________________________________________ Date: _____________ Score: _____________
Procedure 39–2 Steps
Start Time: End Time: Total Time:
Steps
Possible
Points
First
Attempt
Second
Attempt
Third
Attempt
1. Wash hands. Assemble equipment and supplies.
Prepare room. Incorporate critical thinking skills
when performing patient assessment and care.
15
2. Identify the patient, introduce yourself, and explain
the rationale for performance of the procedure. Show
awareness of the patient’s concerns related to the
procedure being performed.
15
3. Assist the patient into sitting position in a chair. 10
4. Have patient put headphones on. Place the red on the
right ear and the blue on the left.
15
5. Complete the test following the manufacturer’s
guidelines. The patient is asked to raise the hand
coinciding to the ear the sound is heard in.
15
6. Continue testing until both ears are evaluated at all
frequencies.
15
7. Plot the findings on the audiogram chart according to
the manufacturer’s guidelines.
15
8. Give the results to the provider for interpretation. 15
9. Clean equipment following manufacturer’s guidelines. 10
10. Wash hands. 15
11. Document procedure in the patient’s chart or EHR. 15
Points Awarded / Points Possible _______/
155
