Quality Pulse Check Audit

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Medication Safety

• DD cupboard locked?

  Yes

  No

  N/A

• S11 cupboard locked?

  Yes

  No

  N/A

• Imprest cupboard locked?

  Yes

  No

  N/A

• Check 3 patient's medication drawers. Number locked?

  0

  1

  2

  3

Resuscitation Trolley

• Days since last check?

  Select 0 1 2 3 4 5 >5

  • 0
  • 1
  • 2
  • 3
  • 4
  • 5
  • >5

• Tagged and locked?

  Yes

  No

  N/A

• Defibrillator plugged in?

  Yes

  No

  N/A

• Oxygen cylinder present and full?

  Yes

  No

  N/A

Patient ID Bands

• Check 3 patients. Number with at least one ID band in situ?

  0

  1

  2

  3

Policy and Protocol Update Sign Off

• Choose one relevant policy or protocol from previous month's update. Percentage of staff that have completed sign off sheet?

Overall Compliance

• Target = 100% = safe

  Safe

  At Risk

  N/A

• Signature of Auditor

  Sign