Practical Skills
Domain 9: Practical Skills
This domain tests procedure safety: vital signs, hand hygiene, bed making, dressings, injections, specimen collection, catheterisation, oxygen and nebulisation. Marks depend on preparation, asepsis and documentation, not speed.
Core rules
- Before any procedure: identify the patient using two identifiers, explain, obtain consent, provide privacy, check allergies and expiry dates, and gather all equipment.
- Follow aseptic technique for dressings, injections and catheterisation; clean from clean to dirty and never touch sterile parts.
- For intramuscular injection, select a safe site such as the ventrogluteal area, clean skin, insert at 90°, and dispose of the needle without recapping.
- Label specimens at the bedside with patient details and time; send promptly.
- Record the procedure, site, patient response and any specimen sent.
Worked example
A patient needs a wound dressing. Reasoning: check the order and allergy, wash hands, prepare a sterile field, remove the old dressing with clean gloves, clean the wound as prescribed, apply the new dressing with sterile gloves, secure it, then document wound appearance and patient comfort.
Traps
Recapping a needle; touching the syringe tip; using an unlabelled specimen; skipping consent; documenting a procedure before completing it.