NQMA - Pressure Injury Audit
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Conducted on
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Auditor's Complete Name:
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Auditor's Job Title:
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Audited Hospital Name:
- CCCNA
- CCNA
- CSHNA
- KSHCNA
- MHNA
- NNINA
- RHNA
- WSHNA
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Select Ward/Unit Name:
- Pediatric Ward 1
- Adult Ward 2A
- Adult Ward 1A
- Pediatric Ward 3
- Adult Ward 3
- Adult Ward 4
- Adult Ward 1/ High Risk Ward
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Select Unit/Ward Name:
- Adult General Intensive Care Unit
- Intensive Care Unit D
- Adult Cardiovascular Intensive Care Unit
- Neuro Critical Care Unit
- Pediatric Intensive Care Unit
- Pediatric Cardiovascular Intensive Care Unit
- Neonatal Intensive Care Unit
- Noenatal Intensive Care Unit & High Dependency Unit
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Select Ward/Unit Name:
- 2F Ward 2
- 3F Ward 1
- 3F Ward 2
- 3F Ward 4
- 4F Ward 1
- 4F Ward 2
- 4F Ward 4
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Select Unit/Ward Name:
- Cardiac Ward 1
- Cardiac Ward 2
- Cardiac Ward 5
- Cardiac Ward 6
- CCU
- PCW/PSDU
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Select Unit/Ward Name:
- MW5
- MW6
- MW7
- MW8
- SW5
- MSW
- FSW
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Select Unit/Ward Name:
- Antenatal Ward Ward 1
- Gynecology Ward Ward 2
- CS Ward Ward 3
- Postnatal Ward Ward 4
- Perinatal Ward
- Gynecology-Oncology Unit
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Select Unit/Ward Name:
- Spinal Cord Injury Rehab Ward 1
- Stroke Rehab Ward 2
- Spinal Cord Injury Rehab Ward 3
- Brain Injury Rehab Ward 5
- Pediatric Rehab Ward 4
- Neuro Rehab Ward
- Adolescent / General Rehab Ward
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Select Unit/Ward Name:
- High Dependency Unit / Ward 1
- Acute Stroke Unit / Stroke Ward
- Neurosurgery Ward 3
- Spine Surgery Ward 5
- Epilepsy Monitoring Unit Ward 6
- Pediatric Ward 3
- Neurology Ward 4
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Patient Medical Record No.:
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Patient Name:
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Age:
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Gender:
Pressure Injury Audit Tool
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1. Was the pressure injury risk assessment completed and documented within 24 hours of admission?
- Yes
- No
- Pending (admitted within the last 24 hours)
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2. Was the pressure injury risk assessment performed during the last shift?
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3. Based on the most recent assessment done by primary nurse, is the patient at risk for pressure injuries?
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4. Based on the assessment by auditor, is the patient at risk for pressure injuries?
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5. Were preventive measures put in place for patients identified as at risk?
6. Document the type, location, and number of pressure injuries:
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HAPI (Hospital-Acquired Pressure Injuries):
- Stage I
- Stage II
- Stage III
- Stage IV
- Unstageable
- Deep Tissue Pressure Injury
- Mucosal Membrane Pressure Injury
- N/A
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HAPI Location (please select one. If the same patient has multiple locations, click the plus sign (+))
- Buttocks
- Coccyx
- Ear
- Elbow
- Foot
- Heel
- Iliac Crest
- Leg
- Neck
- Nose
- Occiput
- Sacrum
- Scapula
- Sole of the foot
- Thigh
- Toes
- Trochanter
- ~Other
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Please specify:
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CAPI (Community-Acquired Pressure Injuries):
- Stage I
- Stage II
- Stage III
- Stage IV
- Unstageable
- Deep Tissue Pressure Injury
- Mucosal Membrane Pressure Injury
- N/A
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CAPI Location (please select one. If the same patient has multiple locations, click the plus sign (+))
- Buttocks
- Coccyx
- Ear
- Elbow
- Foot
- Heel
- Iliac Crest
- Leg
- Neck
- Nose
- Occiput
- Sacrum
- Scapula
- Sole of the foot
- Thigh
- Toes
- Trochanter
- ~Other
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Please specify:
