Checklist

Procedure Checklist Bundle (Admission, Transfer, Cath Lab Pre-procedure)

Three concise, role-specific, savable checklists for common high-risk transitions and procedures (inpatient admission, inter-department transfer, and cath lab pre-procedure). Designed for quick bedside use, auditability, and local tailoring.

Interactive Tool

Procedure Checklist Bundle (Admission, Transfer, Cath Lab Pre-procedure)

Use this bundle to complete a concise, role-specific safety checklist for common high-risk transitions and procedures. Select the checklist you are completing and answer the short, safety-critical items. Only complete the section that applies to the patient and situation. Responses are saved for local audit, training, and continuous improvement. Avoid entering protected health information in this form.

Choose checklist

Pick the checklist you are completing today.

Local reference (optional)

Non-identifying tag such as unit code or internal reference. Do not include patient names or other PHI.

Patient identity confirmed at bedside (two approved identifiers)

Confirm using two approved identifiers.

ID band present and matches the record

Allergies reviewed and documented

Home medications reviewed and reconciliation started or documented

Initial vital signs recorded

Fall, isolation, and safety precautions identified and documented

Handoff script (SBAR or local standard) used by sending team

Monitoring and escalation plan communicated during transfer

Current meds, scheduled meds, and allergies communicated

Mode of transport

Receiving team acknowledged handoff and accepts responsibility

Informed consent documented and available

Contrast allergy status checked and precautions in place

NPO status verified per local policy

IV access established and functioning

Relevant labs available (e.g., creatinine, coagulation) or plan documented

Procedure timeout completed (site, side, equipment, patient, allergies)

Exceptions, concerns, or items needing follow-up

Describe any deviations from expected status or items needing escalation.

Checklist completed by (name or badge ID)

Enter your name, role, or badge ID. Avoid entering patient-identifying information.

Role of person completing checklist

Date/time (local) of completion

Format YYYY-MM-DD HH:MM

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Procedure Checklist Bundle (Admission, Transfer, Cath Lab Pre-procedure)

Procedure Checklist Bundle (Admission, Transfer, Cath Lab Pre-procedure)

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