Ocean View Community Hospital

Saferating OceanView Demonstration Area

UBC Discrepancy Form

Utilize this form to manage, track, trend and perform analysis of (Pyxis, Accudose, Omnicell) and other UBC (Unit Based Cabinets).

Tired of paper based systems, Excel, or other methods to track discrepancies?

Saferating PFT allows for quick entry from existing documentation then use our powerful query engine to track, medication, cabinet, user and and any combination of fields, thus insuring the integrity of the medication process and satisfying numerous regulatory agencies (JCAHO, State Commissions of Pharmacy and CMS)We will customize fields and data elements to need your needs.

	NOTE: Fields marked with "*" are required.

Date of Discrepancy (mm/dd/yyyy):
Use Military Time 16:30
Time:
UBC Name:
Drawer ID:
Pocket Number:
Drug Name:
Expected*:
Found*:
Discrepancy Type:
Current User Name*:
Prior User:
Describe Other Type of Discrepancy: