NNI QT-Patients Communication Board Audit

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Date of day completed

  Yes

  No

  N/A

• Correct MRN

  Yes

  No

  N/A

• Nurse Name

  Yes

  No

  N/A

• Consultant Name

  Yes

  No

  N/A

• Watcher Name

  Yes

  No

  N/A

• Date of Discharge/ELOS

  Yes

  No

  N/A

• Pain Score Ticked/Circled

  Yes

  No

  N/A

• Patient/Family Comments or Notes

  Yes

  No

  N/A

• Patient/Family/Caregiver Orientation with Communication Board upon Admission, Change of Caregiver

  Yes

  No

  N/A

• Goal/Plan for Today

  Yes

  No

  N/A

• Updated every Shift

  Yes

  No

  N/A

• Written Information is agreed with patient/Family or Caregiver

  Yes

  No

  N/A

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• Add signature

  Sign