QAPI Program Utilization_Manual

QUALITY ASSURANCE FORM FOR REVIEW OF CLINICAL RECORDS (quarterly) Date of Evaluation: Name of Staff making evaluation:__________________________________________ CRITERIA SATISFACTORY UNSATISFACTORY 1. Case assignment and management is appropriate, adequate and consistent with the patient care plan, medical regime, and patient needs. 2. Nursing, Therapy services are consistent with professional community health nursing standards. 3. Nursing and other services provided to the patient are coordinated. 4. All services and outcomes are completely and legibly documented, dated and signed IN TIME, in the clinical service record. 5. Confidentiality of patient data is maintained. 6. Findings of the quality assurance programs are used to improve services. 7. were cases assigned to RNs/Ther. as stated in the policy? 8. Were cases assessed within 24 hours of acceptance of the cases. 9. Were SN, Therap., and HHA Visits made on a timely and professional manner as are contained in the manual? 10. Were SN, Therapist, and HHA visit records docu- mented to show the time and duration of each visit? 11. Did RN/PT records on patients' medications show the times and frequencies of such medications? 12. Did RN/PT's supervise all medications? 13. Were progress notes turned in every week as stipulated in the manual? 26