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Drug Dispension & Accountability Log: CRF Wisconsin Madison

1 Formulários  
Header
Descrição

Header

PI Name
Descrição

PI Name

Tipo de dados

text

Protocol or IRB Number
Descrição

Protocol or IRB Number

Tipo de dados

integer

Protocol Short Title
Descrição

Protocol Short Title

Tipo de dados

text

Number of Pages
Descrição

Number of Pages

Tipo de dados

integer

Total Number of Pages
Descrição

Total Number of Pages

Tipo de dados

integer

Drug Dispensation & Accountability Log
Descrição

Drug Dispensation & Accountability Log

Subject Initials
Descrição

Subject Initials

Tipo de dados

text

Subject Study ID
Descrição

Subject Study ID

Tipo de dados

integer

Lot Number(s)
Descrição

Lot Number(s)

Tipo de dados

integer

Unit Dose (e.g. mg)
Descrição

Unit Dose

Tipo de dados

text

Drug Dispensation & Accountability Log: Dispensed to Subject
Descrição

Drug Dispensation & Accountability Log: Dispensed to Subject

Number of Containers Dispensed
Descrição

Number of Containers Dispensed

Tipo de dados

integer

Number of Units Dispensed
Descrição

Number of Units Dispensed

Tipo de dados

integer

Date Dispensed
Descrição

Date Dispensed

Tipo de dados

date

Dispensed by (staff initials)
Descrição

Dispensed by (staff initials)

Tipo de dados

text

Drug Dispensation & Accountability Log: Returned by Subject
Descrição

Drug Dispensation & Accountability Log: Returned by Subject

Number of Containers Returned
Descrição

Number of Containers Returned

Tipo de dados

integer

Number of units returned
Descrição

Number of units returned

Tipo de dados

integer

Date Returned
Descrição

Date Returned

Tipo de dados

date

Verified by (staff initials)
Descrição

Verified by (staff initials)

Tipo de dados

text

Drug Dispensation & Accountability Log: Compliance
Descrição

Drug Dispensation & Accountability Log: Compliance

Expected number of units to be used/taken
Descrição

Expected number of units to be used/taken

Tipo de dados

integer

Actual number of units used/taken
Descrição

Actual number of units used/taken

Tipo de dados

integer

% compliance
Descrição

% compliance

Tipo de dados

integer

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Similar models

Drug Dispension & Accountability Log: CRF Wisconsin Madison

1 Formulários
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Item Group
Header
PI Name
Item
PI Name
text
Protocol or IRB Number
Item
Protocol or IRB Number
integer
Protocol Short Title
Item
Protocol Short Title
text
Number of Pages
Item
Number of Pages
integer
Total Number of Pages
Item
Total Number of Pages
integer
Item Group
Drug Dispensation & Accountability Log
Subject Initials
Item
Subject Initials
text
Subject Study ID
Item
Subject Study ID
integer
Lot Number(s)
Item
Lot Number(s)
integer
Unit Dose
Item
Unit Dose (e.g. mg)
text
Item Group
Drug Dispensation & Accountability Log: Dispensed to Subject
Number of Containers Dispensed
Item
Number of Containers Dispensed
integer
Number of Units Dispensed
Item
Number of Units Dispensed
integer
Date Dispensed
Item
Date Dispensed
date
Dispensed by (staff initials)
Item
Dispensed by (staff initials)
text
Item Group
Drug Dispensation & Accountability Log: Returned by Subject
Number of Containers Returned
Item
Number of Containers Returned
integer
Number of units returned
Item
Number of units returned
integer
Date Returned
Item
Date Returned
date
Verified by (staff initials)
Item
Verified by (staff initials)
text
Item Group
Drug Dispensation & Accountability Log: Compliance
Expected number of units to be used/taken
Item
Expected number of units to be used/taken
integer
Actual number of units used/taken
Item
Actual number of units used/taken
integer
% compliance
Item
% compliance
integer
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