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PIV Extravasation Audit - duplicate
PIV Extravasation Audit - duplicate
Anonymous

PIV Extravasation Audit - duplicate

CHCO Extravasation audit

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Free PIV Extravasation Audit - duplicate Checklist

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Information

  • Conducted on

  • Client/Site

  • Prepared by

  • Room number

  • Is peripheral IV present?

  • Is the insertion site visible?

  • Is there Coban or Coflex used to secure the PIV site?<br>

  • Is there Coban or tape wrapped circumferentially around the limb?

  • Is the dressing intact?

  • Are fluids running at time of audit?

  • When was the IV last assessed?

Audit 2

  • Do another audit on this floor?

  • Room number

  • Is peripheral IV present?

  • Is the insertion site visible?

  • Is there Coban or Coflex used to secure the PIV site?<br>

  • Is there Coban or tape wrapped circumferentially around the limb?

  • Is the dressing intact?

  • Are fluids running at time of audit?

  • When was the IV last assessed?

Audit 3

  • Do another audit on this floor?

  • Room number

  • Is peripheral IV present?

  • Is the insertion site visible?

  • Is there Coban or Coflex used to secure the PIV site?<br>

  • Is there Coban or tape wrapped circumferentially around the limb?

  • Is the dressing intact?

  • Are fluids running at time of audit?

  • When was the IV last assessed?

Audit 4

  • Do another audit on this floor?

  • Room number

  • Is peripheral IV present?

  • Is the insertion site visible?

  • Is there Coban or Coflex used to secure the PIV site?<br>

  • Is there Coban or tape wrapped circumferentially around the limb?

  • Is the dressing intact?

  • Are fluids running at time of audit?

  • When was the IV last assessed?

Audit 5

  • Do another audit on this floor?

  • Room number

  • Is peripheral IV present?

  • Is the insertion site visible?

  • Is there Coban or Coflex used to secure the PIV site?<br>

  • Is there Coban or tape wrapped circumferentially around the limb?

  • Is the dressing intact?

  • Are fluids running at time of audit?

  • When was the IV last assessed?

Audit 6

  • Do another audit on this floor?

  • Room number

  • Is peripheral IV present?

  • Is the insertion site visible?

  • Is there Coban or Coflex used to secure the PIV site?<br>

  • Is there Coban or tape wrapped circumferentially around the limb?

  • Is the dressing intact?

  • Are fluids running at time of audit?

  • When was the IV last assessed?

Audit 7

  • Do another audit on this floor?

  • Room number

  • Is peripheral IV present?

  • Is the insertion site visible?

  • Is there Coban or Coflex used to secure the PIV site?<br>

  • Is there Coban or tape wrapped circumferentially around the limb?

  • Is the dressing intact?

  • Are fluids running at time of audit?

  • When was the IV last assessed?

Audit 8

  • Do another audit on this floor?

  • Room number

  • Is peripheral IV present?

  • Is the insertion site visible?

  • Is there Coban or Coflex used to secure the PIV site?<br>

  • Is there Coban or tape wrapped circumferentially around the limb?

  • Is the dressing intact?

  • Are fluids running at time of audit?

  • When was the IV last assessed?

Audit 9

  • Do another audit on this floor?

  • Room number

  • Is peripheral IV present?

  • Is the insertion site visible?

  • Is there Coban or Coflex used to secure the PIV site?<br>

  • Is there Coban or tape wrapped circumferentially around the limb?

  • Is the dressing intact?

  • Are fluids running at time of audit?

  • When was the IV last assessed?

Audit 10

  • Do another audit on this floor?

  • Room number

  • Is peripheral IV present?

  • Is the insertion site visible?

  • Is there Coban or Coflex used to secure the PIV site?<br>

  • Is there Coban or tape wrapped circumferentially around the limb?

  • Is the dressing intact?

  • Are fluids running at time of audit?

  • When was the IV last assessed?

PIV Extravasation Audit - duplicate
Anonymous

PIV Extravasation Audit - duplicate

CHCO Extravasation audit

Use this Template
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.

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