• Document No.

  • Audit Title unit visit original

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Overall unit

  • Orderly<br>

  • Hallways

Medication room

  • Temperature control

  • Romm temperature

  • Refridgerator temperature

  • Medication preparation area appropriate and clean

  • Medication storage for individual patients appropriate?

Knowldge of staff regarding

  • Csh cart and defibriator

  • How to call. Code

  • Gases turnoff on unit or for rooms

  • Fire/ emergency actions

  • Evacuation practice

Patient room

  • Nurse call systen at bed side in reach

  • Emergency call in bathroom?

  • Crowded, equipment, privacy

  • Clean, ready for occupancy

Patient chart review

  • Physician admission assessment

  • Timely

  • Complete According to organization policy

  • Legible

  • Diagnosis

  • Plan of care

  • Measurable goals

  • Scope of assessment appropriate to patient condition

  • Nursing admission assessment

  • Timely

  • Complete according to organization policy/ form

  • Nursing diagnoses

  • Plan of care

  • Measurable goals

  • Physician review and

  • Nutrition screening effective

  • Functional screeninf effective

  • Special patient populatios assessments

  • Pediatrics

  • Head circumferance

  • Growth - hight abd weight

  • Development -developmental milestones

  • Immunizations

  • Neonatal

  • Apgar score

  • Lumen

  • Neonatal assessment prior to discharge

  • Hip movement

  • Extremities

  • Labor and delivery

  • Geriatrics

  • Psychiatry

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