Information

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Add signature

  • Dressing clean, dry, intake. No blood under dressing.

  • Add media

  • Bio patch in place correctly?

  • Add media

  • Dressing dated. And within in date. Changed every 7days or as needed.

  • Needless connectors are capped using curios?

  • IV tubing labeled with "change dates" and are in date. Change every 96 hrs/4days.

  • TPN/ lipids port labeled and in date. Changed every 24 hrs.

  • All lines connected correctly. No IV lines plugged back into itself.

  • Hand hygiene performed before line access procedures.

  • Scrub the hub 15 seconds prior to each access.

  • Line necessity has been reviewed and documented in care manager. Line meets appropriate reason for CVL.

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