Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Date and Time of Audit:
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Unit:
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Patient MRN:
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Type of Isolation
Compliance Area:
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Is there an order for isolation in the orders section of the chart? <br>(An order is not required per policy however there is a mixed practice for this. The order is what drives the information being in the header of Sunrise )
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Is the order placed by RN?<br>(Mark N/A if no order)
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Is the order placed by MD?<br>(Mark N/A if no order)
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Is the isolation status documented under Treatment and Care section of POE?
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Does the isolation status documented in Treatment and Care section match needed documentation on the HEIC Isolation report?
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Does the isolation status documented in EPIC match isolation needs identified on HEIC Isolation Report?
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Is there evidence of patient/family education documentation regarding: Prevention of Infection and isolation? <br>(Patient education website has specific patient education tools addressing each of these topics:<br> “Prevention of Infection - You are Part of the Healthcare Team”, MRSA, VRE, CDIFF also )<br>
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Were staff observed following correct isolation guidelines? <br>(Based on type of isolation)
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Did family members follow correct isolation guidelines? <br>(Based on type of isolation)
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Were staff able to speak to the need for documentation of negative pressure verification with patients requiring airborne isolation? <br>(Which method of documentation was the unit using- log or isolation sign? )
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Were staff able to identify how to tell if the negative pressure room was working adequately?
Miscellaneous Notes and Findings:
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Are additional Findings Present?
