Dialysis Vascular Access Procedure Checklist Form
Please complete each task in the Dialysis Vascular Access Procedure Checklist to ensure all workflow steps are followed accurately.
Patient identity and procedure confirmed
*
Task completed
Hand hygiene performed and gloves applied
*
Task completed
All required equipment prepared and checked
*
Task completed
Access site inspected and prepped with antiseptic
*
Task completed
Sterile draping and field established
*
Task completed
Local anesthesia administered as needed
*
Task completed
Vascular access created or maintained
*
Task completed
Patency and function of access confirmed
*
Task completed
Access site dressed and secured
*
Task completed
Procedure details documented and post-procedure care initiated
*
Task completed
Submit Checklist
Should be Empty: