Clinical Guidelines for the Safe Use of McKinley T34 Syringe Pump

APPENDIX 4EQUALITY IMPACT ASSESSMENT TOOLTo be completed with the policy document when submitted to the appropriate committee forconsideration, approval and ratification.1. Does the policy/guidance affect one group less ormore favourably than another on the basis of:Yes/No Race No Ethnic origins (including gypsies and travellers) No Nationality No Gender No Culture No Religion or belief NoSexual orientation including lesbian, gay andbisexual people Age NoDisability - learning disabilities, physical disability,sensory impairment and mental health problems2. Is there any evidence that some groups areaffected differently?3. If you have identified potential discrimination, arethere any exceptions valid, legal and/orjustifiable?4. Is the impact of the policy/guidance likely to benegative?5. If so can the impact be avoided? No6. What alternative are there to achieving thepolicy/guidance without the impact?7. Can we reduce the impact by taking differentaction?NoNoNoNoNoNoNoCommentsIf you have identified a potential discriminatory impact of this policy document, please refer it to[insert name of appropriate person], together with any suggestions as to the action required toavoid/reduce this impact. For advice in respect of answering the above questions, pleasecontact [insert name of appropriate person and contact details].Page 32 of 33