Labelling Recommendations Audit Tool PHCS PSS 20120214

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Labelling Recommendations Audit Tool PHCS PSS 20120214 Powered By Docstoc
					Adapted from the audit tool developed by WA Health

           NATIONAL RECOMMENDATIONS FOR USER-APPLIED LABELLING OF INJECTABLE MEDICINES, FLUIDS AND LINES- AUDIT TOOL.

Date:                                                           IntraVENOUS             Subcutaneous
Area:                                                          Intra-ARTERIAL           Miscellaneous
Auditor:                                                            EPIDURAL/IntraTHECAL/REGIONAL                              Please indicate Y,N, or N/A

                                                                                                             Patient   1   2     3    4   5   6    7   8     9 10

                                          Labelling of injectable medicines
1. Does this patient have a syringe of injectable medicine insitu? (eg. PCA, NIKI, epidural)
Does the syringe have a label attached?
Is the label placed correctly so the syringe graduations are not obscured?
Is the patient name recorded on the label?
Is the patient ID recorded on the label?
Is the patient date of birth recorded on the label?
Does the medication(s) recorded on the label match the medication ordered on the medication chart?
Is the total amount of active ingredient recorded on the label in units (eg mg)?
Is the total volume of fluid contained in the syringe recorded on the label in mLs?
Is the concentration calculation (unit/mL) recorded on the label?
Is the diluent recorded on the label?
Is the date of preparation recorded on the label?
Is the time of preparation recorded on the label?
Is the label signed by two staff ?(nursing or medical)

2. Does this patient have a fluid bag or bottle insitu that has injectable medicine added to it? (eg. Iron infusion)
Does the bag or bottle have a label attached?
Is the label applied to the front of the bag or bottle?
Is the label placed correctly so the manufacturer's product name, batch no. and expiry date are not obscured?
Is the patient name recorded on the label?
Is the patient ID recorded on the label?
Is the patient date of birth recorded on the label?
Does the medication(s) recorded on the label match the medication ordered on the medication chart?
Is the total amount of active ingredient recorded on the label in units (eg mg)?
Is the total volume of fluid contained in the bag or bottle recorded on the label in mLs?
Is the concentration calculation (unit/mL) recorded on the label?
Is the diluent recorded on the label?
Is the date of preparation recorded on the label?
Is the time of preparation recorded on the label?
Is the label signed by two staff ? (nursing or medical)
Does the medication ordered match the information on the label?
3. Does this patient have a burette with injectable medicine added to it insitu?
Does the burette have a peel-off label attached?
Is the label placed correctly so the burette graduations are not obscured?
Is the patient name recorded on the label?
Is the patient ID recorded on the label?
Is the patient date of birth recorded on the label?
Does the medication(s) recorded on the label match the medication ordered on the medication chart?
Is the total amount of active ingredient recorded on the label in units (eg mg)?
Is the total volume of fluid contained in the burette recorded on the label in mLs?
Is the concentration calculation (unit/mL) recorded on the label?
Is the diluent recorded on the label?
Is the date of preparation recorded on the label?
Is the time of preparation recorded on the label?
Is the label signed by two staff ? (nursing or medical)
Does the medication ordered match the information on the label?


                            Labelling information for administration lines and catheters

4. Does this patient have an IV line?
Does the IV line have a label attached to indicate the route of administration?
Is it the blue coloured label worded as such: IntraVENOUS?
Does the IV line have a Medicines label attached to indicate the active ingredient?
Does the label identify the date and time that the line is due to be changed?

5. Does this patient have a CVC or PICC line?
Does the CVC or PICC line have a label attached to indicate the route of administration?
Is it the blue coloured label worded as such: CENTRAL VENOUS or IntraVENOUS
Does the CVC or PICC line have a Medicines label attached to indicate the active ingredient?
Does the label identify the date and time that the line is due to be changed?

6. Does this patient have a neural tissue line? (eg. EPIDURAL, intraTHECAL, REGIONAL)
Does the neural tissue line have a label attached to indicate the route of administration?
Is it the yellow coloured label worded as such: EPIDURAL or IntraTHECAL or REGIONAL?
Does the neural tissue line have a Medicines label attached to indicate the active ingredient?
Does the label identify the date and time that the line is due to be changed?
7. Does this patient have a subcutaneous line?
Does the subcutaneous line have a label attached to indicate the route of administration?
Is it the beige coloured label worded as such: Subcutaneous?
Does the subcutaneous line have a Medicines label attached to indicate the active ingredient?
Does the label identify the date and time that the line is due to be changed?
8. Does this patient have a miscellaneous line?
Does the miscellaneous line have a label attached to indicate the route of administration?
Is it the pink coloured label?
Is the route recorded in the blank space on the label - eg intramuscular, intraperitoneal?
Does the miscellaneous line have a Medicines label attached to indicate the active ingredient?
Does the label identify the date and time that the line is due to be changed?

9. Does this patient have a monitoring line insitu? (eg. intra-arterial line, pulmonary-swan ganz)
Does the monitoring line have a label attached to indicate the target tissue?
Is it the red coloured label worded as such: intra-ARTERIAL?
Is it the blue coloured label worded as such: CENTRAL VENOUS?
Does the label identify the date and time that the line is due to be changed?

                                 Labelling continuous infusion administration lines

10. Does this patient have an administration line dedicated for continuous infusions?
Does the line have a label attached?
Does the label identify the active ingredient within the line?
Is the route of administration identified?
Is the label colour coded correctly?
Does the label identify the date and time that the line is due to be changed?

				
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posted:10/3/2012
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