Information
-
Document No.
-
Audit Title
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
-
Did the Admissions representative ask about travel upon hearing the symptoms?
-
Was a mask, gloves, and emesis bag offered to the patient?
-
Was the call made to the triage nurse?
-
Did they wipe down the counter and call housekeeping to clean area of travel?
-
Did triage nurse come dressed in basic PPE?
-
Did the triage nurse make contact with the patient?
-
Did the nurse follow the pre-designated route for ebola patient?
-
Did the nurse enter the patient room?
-
Was physician notified immediately?
-