Skip to main content

Clinician Checklist

    PATIENT DETAILS

    Full Name - *Please capitalise LAST NAME

    Sex:

    Date of birth:





    Clinician Name:


    SETUP CHECKLIST

    PRE-ARRIVAL - Please click YES to confirm

    Verify patient referral has been saved in Patient’s file - If not, copy referral from Approvals to Patient’s file

    Device fully charged:

    Ensure patient is in Vend - Under the correct customer group

    Prep your work area for setup - Order consumable stock if low on supplies (through Vend)


    ARRIVAL - Please click YES to confirm

    Collect Risk assessment questionnaire. Check for completion

    Collect Referral if there is none on file. Check for completion

    Ensure consent form and Medicare form is signed by patient


    CONFIGURE DEVICE

    Patient ID = Vend ID

    Enter patient’s height and weight

    Set Auto-start to 8.00pm - 8.00am

    50Hz notch filter (Alice Devices only)


    Perform setup on patient

    Live Signals Checked


    SPOT CHECK

    Spo2 (%)
    Heart Rate (bpm)

    Offer Post-study consultation - Book via the CPAP Direct Booking Portal

    Issue patient with instruction sheet with Morning Questions

    Include paper-tape for oximeter and nasal cannula affixing

    Return equipment before 11:00AM


    Process sale and consumables in Vend


    Update Patient Tracker for site if “No Show”

    Complete ‘Appointment Status’ column if No Show


    PACKDOWN CHECKLIST

    ON-ARRIVAL - Please click YES to confirm

    Collect Morning questionnaire. Check for completion

    Issue feedback form as an option to complete

    Verify all equipment has returned


    POST DEPARTURE


    QUALITY CHECK STUDY

    Oximetry trace

    EEG trace

    Nasal Flow (PFlow) trace

    ECG trace


    Upload study file to Server via OpenVPN - [Server Drive] > Site


    Scan all patient documents to Server Drive - [Server Drive] > Site > Alphabetised folder > Patient last name

    Risk assessment

    Morning questionnaire

    Consent form

    Medicare Assignment of Benefit form

    Clinician Checklist


    Update Patient Tracker for site - Complete “Appointment Status” column


    Reprocess Device

    Remove batteries and recharge (if applicable)

    Discard adhesives and disposables

    Disinfect with alcohol and ozone if indicated


    Notes




    Send this checklist to....