Medication Refrigerator Temperature Log (For use in 7 day per ...
Medication Refrigerator Temperature Log (For use in 7 day per ...
Medication Refrigerator Temperature Log (For use in 7 day per ...
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<strong>Medication</strong> <strong>Refrigerator</strong> <strong>Tem<strong>per</strong>ature</strong> <strong>Log</strong> (<strong>For</strong> <strong>use</strong> <strong>in</strong> 7 <strong>day</strong> <strong>per</strong> week o<strong>per</strong>ations)<br />
Month/Year______________Location____________________________<br />
Day<br />
Mon<strong>day</strong><br />
Tues<strong>day</strong><br />
Wednes<strong>day</strong><br />
Thurs<strong>day</strong><br />
Fri<strong>day</strong><br />
Satur<strong>day</strong><br />
Sun<strong>day</strong><br />
Date<br />
Time<br />
AM<br />
Temp<br />
Max <strong>in</strong><br />
(35-46F)<br />
M<strong>in</strong> <strong>in</strong><br />
Initials<br />
Time<br />
PM<br />
Temp<br />
Max <strong>in</strong><br />
(35-46F)<br />
M<strong>in</strong> <strong>in</strong><br />
Initials<br />
Corrective Action/Comments<br />
Mon<strong>day</strong><br />
Tues<strong>day</strong><br />
Wednes<strong>day</strong><br />
Thurs<strong>day</strong><br />
Fri<strong>day</strong><br />
Satur<strong>day</strong><br />
Sun<strong>day</strong><br />
Mon<strong>day</strong><br />
Tues<strong>day</strong><br />
Wednes<strong>day</strong><br />
Thurs<strong>day</strong><br />
Fri<strong>day</strong><br />
Satur<strong>day</strong><br />
Sun<strong>day</strong><br />
Please comment on the corrective action taken when the tem<strong>per</strong>ature is outside the accepted range (e.g. door shut after be<strong>in</strong>g left open, will recheck <strong>in</strong> one hour). Contact Facilities<br />
O<strong>per</strong>ations if unit needs to be checked or thermostat needs to be adjusted. Contact Pharmacy for directions on handl<strong>in</strong>g of tem<strong>per</strong>ature sensitive medications.<br />
Items should be rotated, newest stock <strong>in</strong> back, oldest <strong>in</strong> the front<br />
Place thermometer <strong>in</strong> back of unit.<br />
Do not leave door open longer than necessary<br />
Reviewed by___________________________Date______________________<br />
Send Copy of Completed Chart to: <strong>Refrigerator</strong>/Freezer <strong>Log</strong>, C03-008<br />
Keep Orig<strong>in</strong>al on File for Three Years
<strong>Medication</strong> <strong>Refrigerator</strong> <strong>Tem<strong>per</strong>ature</strong> <strong>Log</strong> (<strong>For</strong> <strong>use</strong> <strong>in</strong> 7 <strong>day</strong> <strong>per</strong> week o<strong>per</strong>ations)<br />
Month/Year______________Location____________________________<br />
Day<br />
Mon<strong>day</strong><br />
Tues<strong>day</strong><br />
Wednes<strong>day</strong><br />
Thurs<strong>day</strong><br />
Fri<strong>day</strong><br />
Satur<strong>day</strong><br />
Sun<strong>day</strong><br />
Date<br />
Time<br />
AM<br />
Temp<br />
Max <strong>in</strong><br />
(35-46F)<br />
M<strong>in</strong> <strong>in</strong><br />
Initials<br />
Time<br />
PM<br />
Temp<br />
Max <strong>in</strong><br />
(35-46F)<br />
M<strong>in</strong> <strong>in</strong><br />
Initials<br />
Corrective Action/Comments<br />
Mon<strong>day</strong><br />
Tues<strong>day</strong><br />
Wednes<strong>day</strong><br />
Thurs<strong>day</strong><br />
Fri<strong>day</strong><br />
Satur<strong>day</strong><br />
Sun<strong>day</strong><br />
Mon<strong>day</strong><br />
Tues<strong>day</strong><br />
Wednes<strong>day</strong><br />
Thurs<strong>day</strong><br />
Fri<strong>day</strong><br />
Satur<strong>day</strong><br />
Sun<strong>day</strong><br />
Please comment on the corrective action taken when the tem<strong>per</strong>ature is outside the accepted range (e.g. door shut after be<strong>in</strong>g left open, will recheck <strong>in</strong> one hour). Contact Facilities<br />
O<strong>per</strong>ations if unit needs to be checked or thermostat needs to be adjusted. Contact Pharmacy for directions on handl<strong>in</strong>g of tem<strong>per</strong>ature sensitive medications.<br />
Items should be rotated, newest stock <strong>in</strong> back, oldest <strong>in</strong> the front<br />
Place thermometer <strong>in</strong> back of unit.<br />
Do not leave door open longer than necessary<br />
Reviewed by___________________________Date______________________<br />
Send Copy of Completed Chart to: <strong>Refrigerator</strong>/Freezer <strong>Log</strong>, C03-008<br />
Keep Orig<strong>in</strong>al on File for Three Years
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