| 13/02/2025 | CMH Wards | 10 | Yes:10
No:0
| Fully legible:8
Some parts difficult to read:2
Often difficult to read:0
Completely illegible:0 | Yes: 5
No: 0
Daily IV fluids not indicated: 0
No weekend days included: 5 | Yes:0
No:10
| Yes:2
No:0
No IV additives included:8
| Yes:10
No:0 | Yes:10
No:0 | Yes:8
No:2 | Yes:10
No:0
| Yes:4
No:6 | Average:1.75
Maximum:3
Minimum:1
Median:1.5 | Average:1
Maximum:1
Minimum:1
Median:1 | Yes:0
No:10 | |
| 29/08/2024 | CMH Wards | 10 | Yes:10
No:0
| Fully legible:9
Some parts difficult to read:1
Often difficult to read:0
Completely illegible:0 | Yes: 9
No: 0
Daily IV fluids not indicated: 0
No weekend days included: 1 | Yes:0
No:10
| Yes:2
No:0
No IV additives included:8
| Yes:9
No:1 | Yes:10
No:0 | Yes:3
No:7 | Yes:5
No:5
| Yes:7
No:3 | Average:1.1
Maximum:3
Minimum:0
Median:1 | Average:0.3
Maximum:1
Minimum:0
Median:0 | Yes:2
No:8 | Only signature of the doctor written. No doctors name or practioner number. Patients weight not filled in, Option for output charting not indicated. No patient weight recorded. Doctor’s name not visible but signature is visble. Time that infusion ended not indicated. Total volume of IV fluids administered not indicated, Patients weight not written. Fluids given despite not being prescribed or signed for by a doctor. End time of IV infusion not written. Option for output charting not indicated. Total fluids given not written on some days., End time of infusion only recorded once. Ward and weight of patient not indicated. Option for ouput charting not indicated. Total fluids recieved by patients that day was not indicated. Prescribing doctor not writing the date correctly by only including day and monthn but not year, No recording done for oral fluids prescribed. Weight of patient not included. Output charting option not included. Prescribing doctor not adequately writing in the date-only includes day and month but not year., 0.45% saline prescribed and 0.9% saline given on one of the days. Ward and weight of patient not indicated. Option for output charting not indicated. Non-specific instructions written for oral fluids prescribed- “encourage oral fluids”, No patient ward, weight, output charting option indicated. Date not correctly written by prescribing doctor ( year not indicated). End time of IV infusion not indicated and total daiy volume infused not indicated., Patient details not included at the top of the fluid chart. Patient weight, ward and output charting option not indicated., Patient’s weight not included. No end time or total IV fluid infusion indicated., Weight and output charting option not indicated. End time of IV fluids and total IV fluids not indicated. |
| 22/04/2024 | CMH MOPD | 10 | Yes:10
No:0
| Fully legible:8
Some parts difficult to read:2
Often difficult to read:0
Completely illegible:0 | Yes: 4
No: 0
Daily IV fluids not indicated: 0
No weekend days included: 0 | Yes:0
No:10
| Yes:2
No:0
No IV additives included:8
| Yes:10
No:0 | Yes:10
No:0 | Yes:5
No:5 | Yes:6
No:4
| Yes:10
No:0 | Average:1.7
Maximum:3
Minimum:1
Median:2 | Average:0.3
Maximum:1
Minimum:0
Median:0 | Yes:1
No:9 | Not indicated by prescriber if output charting is needed or not. The ward and weight of the patient not filled in, but other details recorded. Only signed by prescriber, no other identifiable details added., Not indicated by prescriber if output charting is needed or not. The ward and weight of the patient not filled in, but other details recorded.. Only signed by prescriber, no other identifiable details filled recorded., Not indicated by prescriber if output charting is needed or not. The ward and weight of the patient not filled in, but other details recorded. Signed by prescriber and name written, but not legible. No other identifiable details included., Not indicated by prescriber if output charting is needed or not. The ward and weight of the patient not filled in, but other details recorded. Only signed by prescriber, no other details filled in. Frequence of fluids scratched out and rewritten without signature. IV fluids stopped in notes but not on fluid chart – fluids were not given by nurses on the chart after stopped by Dr in the notes., Not indicated by prescriber if output charting is needed or not. The weight of the patient not filled in, but other details recorded. Only signed by prescriber and prescriber number written next to signature., Not indicated by prescriber if output charting is needed or not. The folder number and weight of the patient not filled in. Signed by prescriber and surname written next to it. No prescriber number written. 40 mmol KCL + 2f MgSO4 in 1L N/S 8 hrly prescribed – amount of KCL ampoules not indicated (for more clarity)., Not indicated by prescriber if output charting is needed or not. The weight of the patient not filled in, other details recorded. Signed by prescriber with surname and prescriber number recorded next to it. Blood transfusion recorded on fluid chart by sister (no prescriber details/instruction written on fluid chart for this or in plan in clinical notes)., Not indicated by prescriber if output charting is needed or not. The weight of the patient not filled in, but other details recorded. Signed with prescriber details. 40 mmol (2 amps) kcl in 1 L N/S 12hrly prescribed and then only 20 mmol kcl in 1 L N/S given by sisters for one of the days, only once that day., Not indicated by prescriber if output charting is needed or not. The weight of the patient not filled in, but other details recorded. Only signed by practitioner, no other details included., Not indicated by prescriber if output charting is needed or not. The weight of the patient not filled in, but rest of details filled in. Signed and practice number provided. |
| 21/01/2024 | CMH MOPD | 10 | Yes:9
No:1
| Fully legible:6
Some parts difficult to read:4
Often difficult to read:0
Completely illegible:0 | Yes: 6
No: 1
Daily IV fluids not indicated: 0
No weekend days included: 3 | Yes:0
No:10
| Yes:0
No:1
No IV additives included:9
| Yes:9
No:1 | Yes:8
No:2 | Yes:2
No:8 | Yes:8
No:2
| Yes:3
No:7 | Average:1.33
Maximum:2
Minimum:1
Median:1 | Average:1
Maximum:1
Minimum:1
Median:1 | Yes:1
No:9 | No weight, double prescription, No ward no weight, Written on patient notes, no ward, no weight, No folder number no ward no weight, No folder number no ward no weight, No ward, no weight, no date, No weight , no ward, as above written, No ward, No weight , no ward, no volume administered indicated, No weight. No ward |
| 16/11/2023 | CMH Wards | 10 | Yes:10
No:0
| Fully legible:6
Some parts difficult to read:4
Often difficult to read:0
Completely illegible:0 | Yes: 3
No: 3
Daily IV fluids not indicated: 0
No weekend days included: 0 | Yes:0
No:10
| Yes:5
No:1
No IV additives included:4
| Yes:10
No:0 | Yes:9
No:1 | Yes:5
No:5 | Yes:8
No:2
| Yes:7
No:3 | Average:1.38
Maximum:2
Minimum:0
Median:1.5 | Average:1
Maximum:1
Minimum:1
Median:1 | Yes:0
No:10 | Fluid administration occuring in absence of prescription, fluid administration occuring in absence of prescription, oral fluids not recorded, start and end time of infusion not indicated, start and end of infusion not noted |
| 23/08/2023 | CMH MOPD | 10 | Yes:10
No:0
| Fully legible:10
Some parts difficult to read:0
Often difficult to read:0
Completely illegible:0 | Yes: 10
No: 0
Daily IV fluids not indicated: 0
No weekend days included: 0 | Yes:0
No:10
| Yes:3
No:0
No IV additives included:7
| Yes:10
No:0 | Yes:10
No:0 | Yes:3
No:7 | Yes:10
No:0
| Yes:10
No:0 | Average:1.8
Maximum:3
Minimum:1
Median:2 | Average:0.7
Maximum:2
Minimum:0
Median:1 | Yes:1
No:9 | |
| 02/03/2023 | CMH MOPD | 10 | Yes:10
No:0
| Fully legible:6
Some parts difficult to read:3
Often difficult to read:1
Completely illegible:0 | Yes: 3
No: 2
Daily IV fluids not indicated: 3
No weekend days included: 2 | Yes:10
No:0
| Yes:1
No:2
No IV additives included:7
| Yes:10
No:0 | Yes:10
No:0 | Yes:8
No:2 | Yes:5
No:5
| Yes:4
No:6 | Average:2.5
Maximum:4
Minimum:1
Median:2.5 | Average:3
Maximum:3
Minimum:3
Median:3 | Yes:0
No:10 | Patients drip was out, therefore fluids not received |
