Template / Form for new or changed nursing policies

  1. Hi,

    I am doing research for the Nursing Quality Council at my hospital. They are looking for a form or template that tracks new nursing policies or changes in nursing policies. Maybe I'm not explaining this very well. They are looking a form to include the following or more:

    1) Current policy: i.e. IV dressing change every 96 hours.
    (2) Proposed changed: i.e. IV dressings every 24 hours
    (3) Indication for change: Include rationale for addition, State literature source
    (4) Safety issues:
    (5) Deployment strategy:
    (6) Other comments ( including rationale for addition)

    Any samples/examples, advice would be appreciated. We do not want to re-invent the wheel -- only to make it better here.

    Please let me know if this should be posted elsewhere.

    Thanks for you help/time,

    Librarian to the Nursing Staff at St. Elizabeth Medical Center
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