2011 ISMP MEDICATION SAFETY SELF ASSESSMENT® FOR HOSPITALS KEY

MEDICATION AUTHORITY FORM FOR A STUDENT WHO REQUIRES
1 CUESTIONARIO VALIDADO SMAQ (SIMPLIFIED MEDICATION ADHERENCE QUESTIONNAIRE) CONSISTE
176sudoc Improving Patients Medication Adherence in Chronic Deseases Čulig

2011 ISMP MEDICATION SAFETY SELF ASSESSMENT® FOR HOSPITALS KEY
4.-Medication_Request_Form-SPANISH-rev0313
ATTACHMENT E………………………DCFS INITIAL CHILDREN’S MENTAL HEALTH PSYCHOTROPIC MEDICATION CONSENT

2011 ISMP Medication Safety Self Assessment^® for Hospitals

Key Elements Worksheet I

Key Element	I Patient Information	II Drug Information	III Communication	IV Drug Labeling	V Drug Standardization	VI Devices	VII Environment	VIII Staff Education	IX Patient Education	X QI/RM
Maximum weighted score	166	252	114	92	224	140	138	162	70	492
Individual Hospital Scores
Enter your weighted scores
Enter your % of maximum weighted scores
Aggregate Respondent Scores
Your Bed Size: _____ Enter applicable mean weighted respondent scores
Enter applicable % of maximum weighted respondent scores
Your Setting: ______ Enter applicable mean weighted respondent scores
Enter applicable % of maximum weighted respondent scores
Physician Training: Y N Enter applicable mean weighted respondent scores
Enter applicable % of maximum weighted respondent scores
Individual Hospital Key Element Opportunities for Improvement

2011 ISMP Medication Safety Self Assessment^® for Hospitals

Core Characteristics (C) Worksheet II

Related Key Element

III

VII

VIII

Maximum weighted score

C10

C11

C12

C13

C14

C15

C16

C17

C18

C19

C20

166

176

114

132

140

198

158

108

Individual Hospital Scores

Enter your weighted scores

Enter your % of maximum weighted scores

Aggregate Respondent Scores

Your Bed Size: _____ Enter applicable mean weighted respondent scores

Enter applicable % of maximum weighted respondent scores

Your Setting: ______ Enter applicable mean weighted respondent scores

Enter applicable % of maximum weighted respondent scores

Physician Training: Y N Enter applicable mean weighted respondent scores

Enter applicable % of maximum weighted respondent scores

Individual Hospital Key Element Opportunities for Improvement

Core Number(s)

Related Key Element

Core Number(s)

Related Key Element

2011 ISMP Medication Safety Self Assessment^® for Hospitals

Self-Assessment Items Worksheet III

Item #	Corres-ponding Core #	Self-Assessment Items	Maximum Weighted Score	My Score		Priority #
Item #	Corres-ponding Core #	Self-Assessment Items	Maximum Weighted Score	Weighted Score	Letter Score	Priority #

BAR CODE MEDICATION ADMINISTRATION (BCMA) MANAGER’S USER MANUAL VERSION
BEST POSSIBLE MEDICATION HISTORY WORKSHEET PATIENT FIRST AND LAST
BOSTON PUBLIC SCHOOLS PARENTGUARDIAN AUTHORIZATION FOR MEDICATION ADMINISTRATION

Tags: assessment® for, self assessment®, medication, assessment®, hospitals, safety