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Good Documentation Practices
All missing entries must be explained. A line shall be drawn on all blank spaces to ensure that inappropriate entries are not made at a later date If the blank space is left because an entry is not applicable, “N/A” must be entered. Backdating (entering a date on a day after the entry was made or the task was performed) is not permitted Postdating (entering a date in the future) is not permitted When a document requires an entry upon completion of an activity and the activity was performed but not documented, an explanation (by the performer of the activity) of why there was an omission must be included, signed, and dated
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Good Documentation Practices
Handwritten entries on documents must be made using permanent blue or black ink, pencil is not permitted Correction fluid and ‘white-outs’ are not allowed. Document entries must be made at the time of completing a task and the date and time recorded Signature/ initials entries shall be consistent with the signature recorded in the signature log. No one shall enter a signature or initials for someone else. All entries must be made directly onto the official document. The use of scratch paper, post-it notes, or unofficial notes to record data is not permitted.
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Good Documentation Practices
When a correction is needed, draw a single line through the entire incorrect entry. The errors need to be traceable. Enter the correct information and initial and date the correction. When the reason for the correction is not obvious, place an asterisk or number next to the incorrect entry and explain the correction at the bottom of the page* *explaining this sentence Mistace Mistace Mistace Mistake RR 02/04/10
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Poor Documentation Examples
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Poor Documentation Examples
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Good Documentation Practices
Remember: “if it’s not written down- it’s a rumour” “if it’s written down but not signed and dated, it’s graffiti ”
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Achieving Good Practices (GMP)
“Requires an appropriate culture to be in place throughout an organisation” Doing it right first time every time Being on the lookout for errors Checking things properly
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