Standards › Standard 49 › Forms
Form · DGN-FRM-001 · Version 1.0 · Approved by the ASF Expert Committee
Supports: 49.4
Purpose
Records each dignity observation and each report of a breach of dignity or a refusal of care, and its review.
How to complete
- Observe a sample of interactions each month, and record the findings.
- Record each report of a breach or refusal, and who was involved.
- Record the review and the action taken.
Checks
| Check | Entry |
|---|---|
| Date and ward | Yes |
| Observation result (no breach or breach found) | Yes |
| Report and who was involved | Yes |
| Review and action taken | Yes |
Evidence
| Reference | Note |
|---|---|
| E-006 | ASF Policy Framework v1.2. Adapted. |
| E-009 | ASF Expert Committee consensus. |
Change history
| Version | Date | What changed | Approval |
|---|---|---|---|
| 1.0 | the date of approval | First version | set Expert Committee approval |
E-learning for this document
References
- Accréditation Sans Frontières (2026). ASF Policy Framework v1.2. (E-006)
- Accréditation Sans Frontières (2026). ASF Expert Committee consensus on Standard 1. (E-009)