34.6 Controlled Drug / Opioid Count Sheet
Every ampoule in, every dose out, two signatures every time — the count that catches diversion before a patient is harmed
What it is
A controlled drug and opioid stock record requiring two signatures for every transaction — receipt, administration, wastage, and return. One witness signature is insufficient for opioid governance; this sheet requires both the administering nurse and an independent witness. Running balance must equal physical stock at every shift handover. Discrepancy of even one ampoule triggers immediate investigation before the shift ends.
ASF criterion
Evidence for: Hospital Standard 4, criterion 4.31 (Core) — Opioid Prescribing Is Deliberately Stewarded.
| CONTROLLED DRUG / OPIOID COUNT SHEET · ASF-TOOL-EWD-06 | |||
|---|---|---|---|
| Drug name & strength | Ward | ||
| Form (ampoule / tablet) | Stock at sheet start | ||
| Sheet start date | Opening count verified by (2 sigs) | ||
| Date/Time | Patient name & ID | Qty in (receipt) | Qty out (dose) | Qty wasted | Running balance | Nurse 1 signature | Witness signature |
|---|---|---|---|---|---|---|---|
| Shift closing count — physical stock counted: | Must match running balance ↑ | ||||||
| Closing count verified by (2 signatures): | |||||||
| Discrepancy? (yes/no — if yes, document below): | |||||||
| Discrepancy record: Reported to: | |||||||
ASF-TOOL-EWD-06 · Toolkit 34 — Early Warning & Deterioration · france-asf.fr/tools · ASF original © Accréditation Sans Frontières · CC BY-NC-SA 4.0 · Must comply with national controlled drug regulations · Keep this line on all adapted versions
