NCMC/SPC Case Cart Quality Inspection Sheet - Outpatient Surgery ...

NCMC/SPC Case Cart Quality Inspection SheetCourtesy, Jennifer L. Misajet, RN, BBA, CNORDirector of Surgical Services, Western States Burn CenterFebruary, 2005STERILE PROCESSING CENTER ITEMS NOT AVAILABLE LISTNote: The items listed below are still needed for this case cartIf an item is removed for another case it MUST be written downCase Prepared By: _________________________________________________SPC representative preparing case cart sign hereMISSING INSTRUMENTATION/CARTS/BINS(Instrument Problems? Call 3865)Initial each item as it is addedOPEN:HOLD:__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________MISSING SUPPLIES(Problems? Call #2394)_______________________________OPEN : ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________HOLD : _____________________________________________________________________________________________________________________________________________________________________________________________________________3 of 3