• Audit Title

  • Conducted on

  • Prepared by

  • Location
  • Personnel


  • Medication rooms are clean and uncluttered.

  • Laminar flow hood is used for IV admixture when appropriate.

  • Visual inspection of medication containers: No Issues.

  • Area free of distractions.

  • Medication is appropriately labeled.<br> * Expiration dates, directions, etc..

  • All medications, needles and syringes are secured in locked cabinet or locked room or under constant surveillance.

  • Controlled substances stored to prevent diversion.

  • Medications stored appropriately to maintain stability.

  • Medications, formula, & solutions not expired beyond expiration date.

  • Opened multi-dose vials dated and initialed. Not expired.

  • Code Carts:<br> * Locked and marked with then first drug to expire.<br> * Checked per policy.<br> * Include defibrillator check.<br> * Extra locks kept secured.<br> * All supplies & drugs that are on the inventory list are on the cart.<br> *. Cart is clean.<br> *. O2 tank is >1/2 full

  • Syringes are labeled when in use.

  • Medication refrigerator: Only contain medications for current patients.

  • Breast Milk Refrigerators: Only contain milk for current patients.

  • Patient Bedside: <br> *. IV tubing is labeled per policy.<br> *. Medication is secured and labeled.<br> *. All solutions are labeled at the bedside.

  • Medication Carts: Doors and drawers are locked.


  • Greet the team with smiles and introductions.

  • Have a space designated for the team to conduct interviews and file reviews.

  • Promptly deliver materials required for review to the tracer team.

  • Any additional comments regarding positive or suboptimal issues observed during the tracer.


The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.