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Anesthesia Documentation Compliance
Anesthesia Documentation Compliance
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Created by Qualaris Staff
Anesthesia
Critical Access Hospital
Table of Contents
Audit Form
Audit Form
Anesthesia Documentation Compliance
Required
Observed Date
Anesthesia Documentation Compliance Checklist
Mark all as...
Anesthesia Consent Cosigned by supervising physician
Yes
No
N/A
Type of Anesthesia Indicated by circle
Yes
No
Anesthesia orders signed by supervising physician
Yes
No
N/A
Unnecessary orders crossed out
Yes
No
N/A
Unnecessary orders initialed
Yes
No
N/A
Blank spaces on medications filled out
Yes
No
N/A
Anesthesia Orders Dated
Yes
No
Anesthesia Orders Timed
Yes
No
Pre Anesthesia Eval Completed
CRNA
Anesthesiologist
Post Anesthesia Eval Completed
CRNA
Anesthesiologist
