Accident & Emergency Unit Handover Checklist (Daily)
Date
-
Month
-
Day
Year
Date
Equipment Checklist
*
Rows
Yes
No
N/A
Ventilator is operational
All A&E patient beds are operational
Patient Monitor (uMec 12) is available and operational
Are the weighing scales operational?
Is neonatal, paediatric and adult ambubag available?
Is a fully filled oxygen cylinder available?
Are both adult and paediatric laryngoscopes available?
Thermometer available and operational?
Blood pressure apparatus is available and operational?
Adult and paediatric stethoscope is available and operational?
Syringe and Infusion pumps are operational?
Glucose monitor is operational?
Consumables Checklist
*
Rows
Yes
No
N/A
Any thoughts?
Oralpharyngeal airways available (Sizes 000, 00, 3 and 4)?
Endotracheal tubes available (Sizes 2.5, 3, 4 & 7.5)?
Nasogastric tubes available (Sizes 8-18)?
Cotton wool available?
Disposable gloves available?
Neonatal, paediatric and adult oxygen masks available?
Sterile syringes available?
Suture materials available?
Methylated spirit available?
Blood sample collection bottles available?
How many patients are in the Accident & Emergency Unit?
*
If any, then list their patient number and Wells' PE score
Patient(s) in A&E checklist
*
Rows
Yes
No
N/A
Has the Medical Officer sent for the baseline investigations?
Are the patients vital signs being continuously monitored using the patient monitors and electrodes (If necessary)? And are these results being recorded on the EMR?
Is there a need to insert a central line for the patient?
Any additional comment?
Nurse Handing Over
First Name
Last Name
Signature
Nurse Taking Over
First Name
Last Name
Signature
Submit
Submit
Should be Empty: