Writing procedures demands a consistent format that considers

• Definition

• Purpose

• Who performs activity?

• Steps in the procedure

• Materials needed and how to locate, requisition and dispose of them

• Expected results, precautions, legal implications

• Nurse patient and physician responsibilities and appropriate charting

.

PROCEDURE REVIEW QUESTIONNAIRE

Name of procedure; ————————————————————-

Date of review; ——————————————————————-

Reviewer (s) ———————————————————————-

(Name) (Title) (Service/unit)

———————————————————————-

(Name) (Title) (Service/unit)

Note; The reviewer may wish to carry out the procedure exactly as written before addressing the questions below)

Please circle the number that most accurately reflects your response to the following response.

* When procedure differs from practice, please note discrepancies on separate sheet of paper. Please write recommended revision on separate sheet of paper and return to ………….. by … …………

S.No.	Questions	Yes	No	uncertain	comments
1.	Does the procedure accurately reflect all equipment/materials necessary to carry out the procedure safely/ competently?	1	2	3
2.	Does the procedure reflect equipments used at IUHs?	1	2	3
3.	Is the sequence of steps correct?	1	2	3
4.	Is the sequence of steps complete?	1	2	3
5.	Are the contraindications if any, clearly identified?	1	2	3
6.	Does the scientific rationale provide a meaningful reason for each intervention?	1	2	3
7.	Does the procedure reflects results of current research and state of the art clinical nursing practice?	1	2	3
8.	Does the procedure reflect current clinical practice at IUHs?	1	2	3
9.	Is the procedure in conflict with any other hospital or nursing services policies/ procedures? If so please list.	1	2	3

Additional comments:

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RECOMMENDED ACTION

– The procedure is correct – Discrepancies noted. – Recommended

as written. Recommended revision procedure not

attached. be adopted.

Recommended adoption

Of procedure