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* 1. Organization name:

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* 2. Organization type (select all that apply)

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* 3. Position:

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* 4. Who is responsible for auditing ADC override data at your organization? (select all that apply)

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* 5. How often is your ADC Override compliance audited? (multiple selections apply)

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* 6. How do you define ADC override compliance? (select all that apply)

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* 7. If using an override reason, what types of override categories do you use? (multiple selections apply)

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* 8. When auditing medication overrides, does your organization audit order linkages as well (override order linked to medication order entered by a provider)?

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* 9. How does your organization measure compliance? (multiple selections apply)

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* 10. What is your organization's target ADC override compliance?

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* 11. Additional comments

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