CHATARPATI SHIVAJI SUBHARTI HOSPITAL

ANECDOTAL RECORDING FORM

OBSERVER: Mrs.Neetika (HOD of medicine dept) OBSERVATION DATE: 17/05/2018

OBSERVATION TIME: 10 am
STUDENT NAME : Ms.Neha (staff nurse)
DESCRIPTION OF THE INCIDENT: The staff without checking the medicine schedule gave an antibiotic twice to the patient
during her shift which resulted in serious reaction in the patient and his condition got worse and had to shifted to medical
ICU
DESCRIPTION OF THE LOCATION : male medical ward (Chatarpati shivaji subharti hospital)
ACTIONS /NOTES : The staff was asked to write an explanatory letter along with the demotion to CSSD dept.

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