Standards › Standard 11 › Forms
Form · PRO-FRM-004 · Version 1.0 · Approved by the ASF Expert Committee
Purpose
Records each complication, its treatment, any transfer and its review.
How to complete
- Record each complication at once.
- Record the treatment and any transfer.
- Record the review.
Checks
| Check | Entry |
|---|---|
| Procedure and patient ID | Yes |
| Complication and time | Yes |
| Treatment given | Yes |
| Transferred to hospital (yes or no) and time | Yes |
| Named contact used | Yes |
| Reviewed (date) and action | Yes |
Evidence
| Reference | Note |
|---|---|
| E-009 | Based on the ASF Expert Committee consensus and the WHO Guidelines for Safe Surgical Care and Safe Procedures (2009). |
| 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
- Medical Emergency Protocol Development (MED-01)
- Gastroenterology & Endoscopy Safety Standards (AMB-22)
- Incident Reporting, Just Culture and Open Disclosure (T-09)
- Medication Safety & Storage in Guest Facilities (MED-03)
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)