Fillable NDP 21 MEDICATION ADMINISTRATION AUDIT FORM A M (State of Alabama)

Fill Online, Printable, Fillable, Blank NDP 21 MEDICATION ADMINISTRATION AUDIT FORM A M (State of Alabama) Form

Use Fill to complete blank online STATE OF ALABAMA (AL) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

NDP 21 MEDICATION ADMINISTRATION AUDIT FORM A M (State of Alabama)

On average this form takes 17 minutes to complete

The NDP 21 MEDICATION ADMINISTRATION AUDIT FORM A M (State of Alabama) form is 2 pages long and contains:

  • 2 signatures
  • 0 check-boxes
  • 59 other fields

Country of origin: US
File type: PDF

U.S.A. forms for State of Alabama

BROWSE STATE OF ALABAMA (AL) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
NDP 21
January 2020 This is a Mandatory form used by MAS nurse to complete
training with MAC workers, nurses on ALL Medication errors (except
documentation errors). To be kept in training file 5 years
MEDICATION ADMINISTRATION AUDIT FORM
A
gency/Location ______________________ Date __________________
M
AC Worker_____________________ MAS Nurse__________________
R
eason for Audit/Observation: ___________________________________
#
Criteria
Y
N
N/A
Comments
1
Does person served have any
contact/infection control precautions?
Did staff follow precautions?
2
Did staff use proper handwashing technique?
3
Did staff prepare meds for more than one
person?
4
Were meds pre-poured/set-up?
5
Did staff use 3 checks?
• When removing meds from storage
• When opening medication/removi
ng
f
rom packaging/container
• Prior to assisting/administering
6
Did person check to verify allergies?
7
Did staff use the 7 Rights of med
administration?
• Right person
• Right time
• Right med
• Right dose
• Right route
• Right reason
• Right documentation
8
Were there any distractions/interruptions?
• Avoidable
• unavoidable
9
Did staff observe person taking med/check to
ensure po meds were swallowed?
10
Did staff tell person what meds they were
taking?
11
Did staff document on MAR immediately after
assisting/administering meds?
12
Did staff ensure med container was clean
prior to returning to proper storage?
13
Can staff state the following:
• Agency policy/procedure related to
assisting/administering meds
• 7 rights of med administration
NDP 21
January 2020 This is a Mandatory form used by MAS nurse to complete
training with MAC workers, nurses on ALL Medication errors (except
documentation errors). To be kept in training file 5 years
• When the 3 checks must be
performed
• What to do in case an error occurs
ALL STAFF MUST SIGN THE BACK OF THIS FORM
SIGNATURES/CREDENTIALS MANDATORY
MAC __________________________________ DATE ___________
MAS __________________________________ DATE ___________
click to sign
signature
click to edit
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

NDP 21 MEDICATION ADMINISTRATION AUDIT FORM A M (State of Alabama)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 9 August 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document