Information

  • Unit

  • Building

  • Floor

  • Conducted on

  • Prepared by:

  • Flashlights - Your department must have a supply of flashlights and extra batteries (and manual call bells for inpatient areas) in case of power outage. One or more of the employees in your area were asked to locate one. Ideally, batteries should not be kept in the flashlights unless they are being used as the battery may leak and damage the flashlight so that it will not be usable in an emergency.

  • Employees were able to locate a flashlight

  • Employees not able to locate a flashlight

  • Plan of action - if required, please send me your next steps within two weeks unless otherwise indicated

  • RACE - Staff must know what to do when the fire alarm sounds. This survey one or more of your staff were asked what the A in RACE stands for. Staff should know where the closest fire alarm pull station is and who to call (4-4444) if they discover a fire or smoke.

  • Employees knew

  • Employees did not know

  • Plan of action - if required, please send me your next steps within two weeks unless otherwise indicated

  • Patient Information - All employees of OHSU must know that they cannot divulge patient information, including such details as discharge or appointment dates, even to those who appear official such as law enforcement officers, surveyors, etc. one or more of your staff were asked what they would do if asked for information by a police officer.

  • Employees understood

  • Employees did not understand

  • Plan of action - if required, please send me your next steps within two weeks unless otherwise indicated

  • Bathroom Rescue - Staff must be able to quickly access a locked restroom door in order to rescue someone in distress. In order to "pass" they must be able to open the door within three minutes.

  • Number of seconds to first response

  • Number of seconds to "rescue"

  • Plan of action - if required, please send me your next steps within two weeks unless otherwise indicated

  • Pull Cords - In restrooms where there is an alarm pull cord, the cord must be accessible to someone lying injured on the floor. This means the cord cannot be wrapped around anything and must hang free to about six inches from the floor.

  • Plan of action - if required, please send me your next steps within two weeks unless otherwise indicated

  • Doors may not be propped, wedged or blocked open. This means there can be NO doorstops, wedges, kick down door stops, equipment, chairs or other items preventing doors from closing and latching. Doors cannot be tied open or latches taped over.

  • Plan of action - if required, please send me your next steps within two weeks unless otherwise indicated

  • Resource - Environmental Health & Radiation Safety at 503.494.7795
    EC Highlights at http://www.ohsu.edu/xd/about/services/integrity/EHRS/general safety/upload/door-wedges.pdf
    http://www.ohsu.edu/xd/about/services/integrity/ehrs/general-safety/upload/door-wedges.pdf

  • Corridors, exits and exit discharges must clear of obstructions. All items must be on wheels and kept to one side of the hallway. The fire doors must be able to close and latch. As a general rule, if you can see an exit sign, there should be a clear path to that sign-NOT an obstacle course.

  • Plan of action - if required, please send me your next steps within two weeks unless otherwise indicated

  • Fire sprinklers must have an escutcheon or seal to cover the hole in the ceiling tile where the sprinkler is placed. Any found in need of repair or replacement will be reported to Facilities.

  • Escutcheons intact

  • Escutcheons not intact (EHRS will report to Facilities)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.