General Hospital • Operating Theatre

Narcotic Drug Monitoring List

Location:
Page No:
SN Date Time Patient Name MRN Anesthetist / Doctor Given
(Qty/Amps)
Wasted
(Qty/Amps)
Balance
(Running Total)
Administered By
(Sign / ID)
Witnessed By
(Sign / ID)
- Balance Brought Forward / Received
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

MANDATORY RULE: Every administration must be recorded immediately. Any wasted, dropped, or broken ampoule must be witnessed by a second registered nurse or physician and recorded in the "Wasted" column. The running balance must be verified at every shift handover.

Page Verified By (Charge Nurse / Manager)

Pharmacy Audit (If Applicable)