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Evergreen Healthcare nn Fonr`s <br /> IN SERVICE EDUCATION SUMMARY <br /> MARY <br /> Facility/Department: 4 <br /> Date and Time.: Duration: <br /> a <br /> All- <br /> Topic: -Conducted by: � 1,� <br /> Content or.'uma45 onserv�ce: ail <br /> OA) / ! oto" �24 e <br /> 61,4/2 /1 / <br /> Method of Presentation-Attach all presentation materials(check all that ly): <br /> ©Lecture ®Handouts ODemonstration OVi.deo JAudio nteractive Dialogue <br /> Method of Testing/Evaluation(check all that apply): <br /> ©Written Test JOral Test OReturn Demonstration ®Skills Validation nteractive Dialogue <br /> tiam.e( rint Si nature Sob Title <br /> LA <br /> U1413.) <br /> � �---- <br /> . P <br /> VIOLPAj <br /> 1 ` <br /> l lv d L V'// <br /> ► <br /> ,I <br /> 1 � I <br /> I i <br /> I ; <br /> i <br /> This document contains privileged and confidential information used by the facility CQI Committee,to identify and to respond to Continuous Quality <br /> Improvement issues in the facility,as well as to develop means to evaluate the facility s response to Continuous Quality Improvement issues.Itis a <br /> CQI Committee Record that shall be protected from disclosure.. <br /> Forms\lnservice—Inservice Education Summary_1883 page i of 1 <br /> Published July 201 i <br />