Nursing Audit Checklist

• Audit on

  Date

• Prepared by

• Location
  Address

• Room/Unit #

• Admissions date

  Date

Medical Record

• Medication tray is loaded correctly in the medication room

  Yes

  No

• All medications and supplies on the tray are for only 1 patient

  Yes

  No

• The RN went directly to the patient room with the correct tray for medication administration

  Yes

  No

• After use, the RN wiped down the medication tray with the purple saniwipes

  Yes

  No

• The medication tray was returned directly after use to the proper location.

  Yes

  No

undefined

• RN name

• Location/Room #

• Date and Time

  Date