2024 Infection Control Dept Tracer

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Infection Control

• Are items stored at least 36" from electrical panels?

  Yes

  No

  N/A

• No items stored within 18" of ceiling

  Yes

  No

  N/A

• Are electric panels properly secured or locked?

  Yes

  No

  N/A

• Are electric panel switch labels accurate and are all spares in the off position?

  Yes

  No

  N/A

• Are all mechanical and electrical rooms clean and have no storage? Indicate which rooms are not clean in the notes section.

  Yes

  No

  N/A

• Are medical gas zone shut-off valves accessible and unobstructed?

  Yes

  No

  N/A

• Are medical gas zone shut-off valves properly labeled for area served?

  Yes

  No

  N/A

• Do clean utility, sterile storage, medication rooms, and other clean/sterile areas have positive air pressure to the corridor/adjacent areas?

  Yes

  No

  N/A

• Do soiled utility, trash, hazardous waste, and other dirty rooms have negative air pressure to the corridor/adjacent areas?

  Yes

  No

  N/A

• Clean utility rooms contain only clean/sterile items?

  Yes

  No

  N/A

• Soiled utility rooms contain contaminated/soiled items only? Door is locked

  Yes

  No

  N/A

• All clean supplies stored off of the floor?

  Yes

  No

  N/A

• Are supplies within expiration dates? (Random checks)

  Yes

  No

  N/A

• Is clean linen covered?

  Yes

  No

  N/A

• Is clean linen kept separate from the dirty linen disposal?

  Yes

  No

  N/A

• Are medication refrigerator logs maintained and up-to-date? Are temperatures within range?

  Yes

  No

  N/A

• Are patient food refrigerator logs maintained and up-to-date? Are temperatures within range?

  Yes

  No

  N/A

• Are patient food freezer logs maintained and up-to-date?

  Yes

  No

  N/A

• Are patient food freezer temperatures within range?

  Yes

  No

  N/A

• Are medicines and food stored in separate refrigerators?

  Yes

  No

  N/A

• Patient food items have expiration dates and are not expired?

  Yes

  No

  N/A

• The only items located under sinks are items allowed by policy?

  Yes

  No

  N/A

• Return and supply air diffusers are free from dust?

  Yes

  No

  N/A

• Countertops in good repair with no chips or missing laminate?

  Yes

  No

  N/A

• Furniture is in good repair and not dirty or soiled?

  Yes

  No

  N/A

• All multidose medication vials are dated with a 28 day expiration date

  Yes

  No

  N/A

• Glucometer(s) are clean

  Yes

  No

  N/A

• Glucometer controls are dated with correct expiration date

  Yes

  No

  N/A

• No stained ceiling tiles noted

  Yes

  No

  N/A

• No corrugated boxes noted in area

  Yes

  No

  N/A

• No Call Bells looped around bars

  Yes

  No

  N/A

• Crash cart log(s) current with dates checked

  Yes

  No

  N/A

• Crash cart(s) plugged into red plug

  Yes

  No

  N/A

• Egress hallways are free of clutter

  Yes

  No

  N/A

• All oxygen cylinders secured

  Yes

  No

  N/A

• Oxygen cylinders (Full and Partial) are kept separated from Empty cylinders

  Yes

  No

  N/A

• If oxygen cylinders are kept in a supply room there is a sign on the door to signify Oxygen stored

  Yes

  No

  N/A

• No expired Biomed sticker found

  Yes

  No

  N/A

• Yes

  No

  N/A