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Hemoglobin Measurement -Form Fill
Q1
Did the nurse wash hands?
Yes
No
Q2
Did the nurse inform the pregnant woman about the procedure?
Yes
No
Q3
Did the nurse wear gloves?
Yes
No
Q4
Did the nurse clean the tip of the pregnant woman s finger with a spirit swab?
Yes
No
Q5
Did the nurse prick the finger with a lancet?
Yes
No
Q6
Did the nurse allow a blood drop to form on the fingertip?
Yes
No
Q7
Did the nurse discard the first drop of blood?
Yes
No
Q8
Did the nurse use a pipette to suck the blood drop?
Yes
No
Q9
Can you tell me up to which mark you need to suck the blood?
20 cu.mm
Others
Don�t know
Q10
Did the nurse clean the pregnant woman s finger?
Yes
No
Q11
Did the nurse wipe the tip of the pipette?
Yes
No
Q12
Did the nurse transfer the blood to the Hb tube?
Yes
No
Q13
Can you tell me what the solution inside the Hb tube is?
N/10 HCL
Others
Don�t know
Q14
Did the nurse wait for ten minutes?
Yes
No
Q15
Did the nurse dilute the acid by adding distilled water drop by drop?
Yes
No
Q16
Did the nurse use a stirrer to mix?
Yes
No
Q17
Did the nurse match the color of the comparator?
Yes
No
Q18
Did the nurse note down the reading in gms%?
Yes
No
Q19
Can you tell me which reading is to be considered, the lower or upper meniscus?
Lower meniscus
Upper meniscus
Others
Don�t know
Q20
Did the nurse dispose of the used lancet in a puncture proof container?
Yes
No
Q21
Did the nurse discuss the results with the pregnant woman s?
Yes
No
Q22
Did the nurse dispose the gloves as per protocol (IN 0.5 CHLORINE SOLUTION)?
Yes
No
Q23
Did the nurse rinse Hb chamber and pipette with N/H10?
Yes
No
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