Global Patient Safety Goals Implementation Form PDF

Global Patient Safety Goals Implementation Form Complex Name: Month: Year: 202 Goal 1: Correct Patient Identification Before: Giving Emergency Medication - Conducting a Blood Draw or Taking Samples for a Medical...

Global Patient Safety Goals Implementation Form Complex Name: Month: Year: 202 Goal 1: Correct Patient Identification Before: Giving Emergency Medication - Conducting a Blood Draw or Taking Samples for a Medical Examination - Providing Treatment or Performing a Medical or Surgical Procedure. Comment/corrective weeks Week 4 Week 3 Week 2 Week 1 action Number of Section 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 5 4 3 2 1 times verified √ Clinics × √ Dental clinic × √ Emergency × √ Laboratory × √ Pharmacy × Report approver: Name: ………………………… Position: ………………………… Signature: : …………………………Date: ………………………  Global Patient Safety Goals Implementation Form Complex Name: Month: Year: 202 nd 2 Goal: Improve Effective Communication (Verbal and Telephone Orders) The verbal or The telephone order is command Name of Type of documented and has been His / Her Name Order His / Her comments signed in the written person giving commun Date Job Receiver Job verbal/ Medical Record with Re-read it command -ication Medical Patient name Section telephone T 24 Hrs. Confirm Record order The order occurred Not Not Te identic matchin identical matchi lep verb al g √ ng ho al × × √ ne 1 2 3 4 5 Report approver: Name: ………………………… Position: ………………………… Signature: : …………………………Date: ………………………  Global Patient Safety Goals Implementation Form Complex Name: Month: Year: 202 rd 3 Goal: Objective 3: Improving Safety of High-Alarm Medications High-Alert High-alert High-alarm Medications are only medications are List of high-alert medications are Dispensed by a kept separately in drugs is up-to-date identified by red Comment / Corrective Action Pharmacist upon a locked, secure signs and approved Traffic history Section T Doctor's Request cupboard × √ × √ × √ × √ 1 2 Pharmacy 3 4 5 Emergency 1 * In the event that there are high- 2 alert medications according to the 3 decision of the technical 4 committee 5 Report approver: Name: ………………………… Position: ………………………… Signature: : …………………………Date: ………………………  Global Patient Safety Goals Implementation Form Complex Name: Month: Year: 202 th 4 Goal: Ensure that Surgeries are Performed in the Correct Location and with the Correct Procedures on the Correct Patient A time out was The location of the The dentist has signed The time taken was conducted to check: tooth is indicated on the time-out procedure documented in the Patient identity Surgery site the dental card and x- History of form Medical Record Health file Comment / Corrective Action Surgical procedure rays if possible. number tooth T extractions Not Not Not Not identical identical identical identical matching matching matching matching √ √ √ √ × × × × 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Report approver: Name: ………………………… Position: ………………………… Signature: : …………………………Date: ………………………  Global Patient Safety Goals Implementation Form Complex Name: Month: Year: 202 th 5 Goal: Reduce Risk of Healthcare Associated Infections Week 4 ----- Week 3 ----- Week 2 ----- First Week Categories After Touching Before Touching After Touching Before Touching After Touching Before Touching After Touching Before Touching # Patient Patient Patient Patient Patient Patient Patient Patient Not Identical Not Identical Not Identical Not Identical Not Identical Not Identical Not Identical Not Identical Matching × √ Matching × √ Matching × √ Matching × √ Matching × √ Matching × √ Matching × √ Matching × √ Nursing Doctors Dentists Dental Assist Rays X- Complic Sample ation 3 Total Report approver: Name: ………………………… Position: ………………………… Signature: : …………………………Date: ………………………  Global Patient Safety Goals Implementation Form Complex Name: Month: Year: 202 6th Goal: Reduce Risk of Patients being Harmed as a Result of Falls. Documenting Instructions “"Sample is taken for Fall Risk Assessment by Fall Risk Assessment by "Sample is Provided to Patient & those who have Physician Is Completed Nursing is Completed and Taken From the his/her Family to Avoid completed a month And Documented Documented Files of Patients Risk of Falling or more of the initial Comment / Corrective Action medical evaluation at Risk of # Falling" visit" × √ × √ × √ Date of Patient's Medical Record No. Initial Evaluation 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 Report approver: Name: ………………………… Position: ………………………… Signature: : …………………………Date: ………………………