Apheresis Port Access Checklist Form
Complete this checklist to ensure all required steps for Apheresis Port Access readiness are verified.
Checklist: Preparation Steps
Supplies and Equipment Confirmed
*
Sterile gloves available
Antiseptic solution prepared
Appropriate port needles ready
Dressing supplies at hand
Hand Hygiene Performed
*
Hands washed or sanitized immediately before procedure
Patient Verification
*
Patient identity confirmed per facility protocol
Procedure explained to patient
Port Site Assessment
*
Site visually inspected for redness, swelling, or drainage
Site palpated for tenderness or abnormalities
Appropriate Personal Protective Equipment (PPE) Worn
*
Mask worn
Eye protection worn
Port Flushing Solution Prepared
*
Flush solution (e.g., saline) drawn up and labeled
Aseptic Technique Maintained
*
Sterile field established and maintained
Checklist Completion Notes (optional)
Port Access Ready for Procedure
*
All steps above completed and confirmed
Submit Checklist
Should be Empty: