Pharmacy Near Miss Log Template

Use this Pharmacy Near Miss Log Template to record dispensing errors, identify trends, and implement corrective actions for continuous process improvement.

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Pharmacy Near Miss Log Template

Log Header And Context

Near Miss Entry

Periodic Review

Checklist by GoAudits.com – Please note that this checklist is intended as an example. We do not guarantee compliance with the laws applicable to your territory or industry. You should seek professional advice to determine how this checklist should be adapted to your workplace or jurisdiction.

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Pharmacy Near Miss Log Template

Use this Pharmacy Near Miss Log Template to record dispensing errors, identify trends, and implement corrective actions for continuous process improvement.

1. Pharmacy name and branch

2. Period covered by this log (week or month)

3. Typical staffing level during the period

4. Notable workload or service pressures during the period

5. Responsible pharmacist

1. Date and time the near miss was identified

2. Medication or product involved

3. Strength, form, and quantity involved

4. Stage at which the near miss was detected (picking, assembly, labelling, accuracy check, or handout)

5. Type of near miss

6. Contributing factors

7. Brief description of what happened

8. Action taken at the time to correct it

9. Potential harm had it reached the patient

10. Recorded by

11. Checked or verified by

1. The log has been reviewed within the agreed timeframe

2. Recurring themes or trends have been identified

3. High-risk or repeated near misses have been escalated

4. Corrective actions have been agreed with a named owner and target date

5. Standard operating procedures have been updated where needed

6. Learning has been shared with the whole pharmacy team

7. The date of the next review has been scheduled