UNIT SPECIFIC

Department/Unit: OB-GYNE IVF Review period: 2017

Inpatient Management of Uncontrolled Diabetic Pregnant Woman
Criteria:
1. Quantity of food taken is measured 5. Use of sliding scale or correction dose
2. Pre and post meal blood glucose check is documented 6. Reassessment of blood after episode of hypo/hyperglycemia
3. Urine dipstick taken and recorded every void 7. Proper technique of insulin injection
4. Referral to diabetic nurse and dietician 8. CTG to be monitored needed, CTG to be applied after palpation done

KEY CODES: Present/YES = 1 Absent/No = 0 Not Applicable = N/A

Criteria
No. Patient MR # Date Reviewed Total Compliance Comments
1 2 3 4 5 6 7 8
1
2
3
4
5
6
7
8
9
10
Total Compliance - Each Criteria
Submitted by: Leejean T. Nasis 31334 Date ______________________________
 UNIT SPECIFIC

Department/Unit: OB-GYNE IVF Review period: July 2017

Inpatient Management of Uncontrolled Diabetic Pregnant Woman
Criteria:
1. Quantity of food taken is measured 5. Use of sliding scale or correction dose
2. Pre and post meal blood glucose check is documented 6. Reassessment of blood after episode of hypo/hyperglycemia
3. Urine dipstick taken and recorded every void 7. Proper technique of insulin injection
4. Referral to diabetic nurse and dietician 8. CTG to be monitored needed, CTG to be applied after palpation done

KEY CODES: Present/YES = 1 Absent/No = 0 Not Applicable = N/A

Criteria
No. Patient MR # Date Reviewed Total Compliance Comments
1 2 3 4 5 6 7 8
1 1497314 21.07.2017 1 1 1 1 N/A 1 1 1 100%
2
3
4
5
6
7
8
9
10
Total Compliance - Each Criteria 81.8 100 100 100 100 100 100 100 97.53%
Submitted by: Leejean T. Nasis 31334 Date: 22.07.2017