Get Providence Hospital Phy00179 2006-2026

The Providence Hospital PHY00179 is a narcotic discrepancy form designed to document and resolve discrepancies related to narcotics. This guide will provide step-by-step instructions on how to fill out the form accurately and efficiently online.

Follow the steps to complete the Providence Hospital PHY00179 form online.

1. Click ‘Get Form’ button to access the form and open it in your chosen digital editor.
2. In the first section, enter today’s date in the specified field.
3. Record the date of the discrepancy occurrence in the next field.
4. Indicate the PYXIS Station from which the discrepancy originated.
5. Specify the drug involved in the discrepancy.
6. Provide the prior access time for the drug in the relevant field.
7. For follow-up reports, mark whether it is a new report or follow-up report of discrepancy from the PYXIS printout.
8. Enter the strength of the medication in the designated area.
9. Select the dosage form that corresponds to the drug listed.
10. Indicate if the discrepancies can be resolved without the prior department access involvement.
11. For new discrepancies, fill in the discovering person's name and their signature.
12. Include the signature of a witness to the discrepancy.
13. For follow-up discrepancies, provide the name of the resolver and their signature.
14. Add the signature of a witness for the follow-up discrepancies.
15. Complete the circumstances section with a detailed description of the incident.
16. Fax a copy of the report to pharmacy at 639−2793 within 24 hours of the discrepancy.
17. Return the original narcotic discrepancy form to the pharmacy.
18. If you have any questions, refer to Nursing Policy 5.01.102 for guidance.
19. Once completed, you can save changes, download, print, or share the form as needed.

Ensure all sections are completed accurately before submitting the form online.