Hospital Dashboard

Discharge Checklist

Safe Childbirth Checklist Before Discharge (Step 4)

        Date :
        Admission Consent :
        Blood Transfusion Consent :
        Cost Consent :
        Procedure Consent :
        High Risk Consent :
        Anesthesia Consent :
        LAMA/DOR Consent :
        Discharge Consent :
        Safe Childbirth Checklist Step 1 :
        Safe Childbirth Checklist Step 1 :
        Safe Childbirth Checklist Step 2 :
        Safe Childbirth Checklist Step 3 :
        Safe Childbirth Checklist Step 4 :
        Safe Childbirth Checklist (Step 4) :

Confirm stay at facility for 24 hours after delivery

Does mother need to start antibiotics?

Is mother’s blood pressure normal?

Is mother bleeding abnormally?

Does baby need to start antibiotics?

Is baby feeding well?
        Discuss and offer family planning options to mother
        Arrange follow-up and confirm mother

Danger Signs

Mother has any of
        Bleeding
        Severe abdominal pain
        Severe headache or visual disturbance
        Breathing difficulty
        Fever or chills
        Difficulty emptying bladder
        Epigastric pain
Baby has any of:
        Fast/difficult breathing
        Fever
        Unusually cold
        Stops feeding well
        Less activity than normal
        Whole body becomes yellow
        Pharmacy Replacement :
        Billing Completed :
        Discharge summary explained and handed over :
        Prescription explained and handed over :
        Report handed over :
        Iv Cannula Removed :
        Hospital Dress Changed :
        Hospital belonging checked and taken back :
        Consultant informed :
       Pending report informed: