AHS 2020 Staff Interview Questions for Survey Readiness

• Conducted on

  Date

• Prepared by

• Campus

• Department

Staff member #1

• If a patient asks you to notify his/her family or PCP of his/her admission to the hospital, what is your process? (RI.01.02.01)

  Yes

  No

  N/A

• Where do you locate the Safety Data Sheets (SDS) for the chemicals you use in your workspace? Please show me. (EC.02.01.01 EP 11)

  Yes

  No

  N/A

• What are the Instructions for Use (IFUs) or Manufacturers' Instructions for Use (MIFUs)? and where can you access them? (IC.02.02.01-main; TS.03.02.01; WT.04.01.01)

  Yes

  No

  N/A

• Where is the nearest eyewash station? (EC.02.02.01 EP 5)

  Yes

  No

  N/A

• Where would you locate the Preventive Maintenance (PM) date on a piece of medical equipment? (EC.02.04.03 EP 2)

  Yes

  No

  N/A

• What is your process if PM stickers is past due? (EC.02.04.03 EP 2)

  Yes

  No

  N/A

• What is your process if a door does not close all the way or latch? (EC.02.05.01 EP 15-16)

  Yes

  No

  N/A

• What is your process to check for expired supplies? (WT.01.01.01 EP 2)

  Yes

  No

  N/A

• Can tape be used on medical equipment? (IC.02.01.01 EP 1)

  Yes

  No

  N/A

• How do you properly store/secure oxygen E tanks? (EC.02.05.09 EP 12)

  Yes

  No

  N/A

• When does a nurse notify the provider that a patient has been placed into Restraints/Seclusion? (PC.03.05.09)

  Yes

  No

  N/A

• How do you keep PHI secured in your department? (IM.02.01.01 EP 1)

  Yes

  No

  N/A

• How do you secure medications and/or biologicals on your unit? (MM.03.01.01 EP 6)

  Yes

  No

  N/A

• Radiology or OR Only: How do you know lead aprons are checked and are current/ok to use? (EC.02.02.01 EP 7)

  Yes

  No

  N/A

• JGPH Only: When does EVS complete their cleanliness rounds? (LD.04.01.01 EP 3)

  Yes

  No

  N/A

• JCPH Only: What is the disinfectant type that we use to clean areas? (IC)

  Yes

  No

  N/A

• JGPH Only: When are nursing EOC rounds completed? (IC)

  Yes

  No

  N/A

Staff member #2

• If a patient asks you to notify his/her family or PCP of his/her admission to the hospital, what is your process? (RI.01.02.01)

  Yes

  No

  N/A

• Where do you locate the Safety Data Sheets (SDS) for the chemicals you use in your workspace? Please show me. (EC.02.01.01 EP 11)

  Yes

  No

  N/A

• What are the Instructions for Use (IFUs) or Manufacturers' Instructions for Use (MIFUs)? and where can you access them? (IC.02.02.01-main; TS.03.02.01; WT.04.01.01)

  Yes

  No

  N/A

• Where is the nearest eyewash station? (EC.02.02.01 EP 5)

  Yes

  No

  N/A

• Where would you locate the Preventive Maintenance (PM) date on a piece of medical equipment? (EC.02.04.03 EP 2)

  Yes

  No

  N/A

• What is your process if PM stickers is past due? (EC.02.04.03 EP 2)

  Yes

  No

  N/A

• What is your process if a door does not close all the way or latch? (EC.02.05.01 EP 15-16)

  Yes

  No

  N/A

• What is your process to check for expired supplies? (WT.01.01.01 EP 2)

  Yes

  No

  N/A

• Can tape be used on medical equipment? (IC.02.01.01 EP 1)

  Yes

  No

  N/A

• How do you properly store/secure oxygen E tanks? (EC.02.05.09 EP 12)

  Yes

  No

  N/A

• When does a nurse notify the provider that a patient has been placed into Restraints/Seclusion? (PC.03.05.09)

  Yes

  No

  N/A

• How do you keep PHI secured in your department? (IM.02.01.01 EP 1)

  Yes

  No

  N/A

• How do you secure medications and/or biologicals on your unit? (MM.03.01.01 EP 6)

  Yes

  No

  N/A

• Radiology or OR Only: How do you know lead aprons are checked and are current/ok to use? (EC.02.02.01 EP 7)

  Yes

  No

  N/A

• JGPH Only: When does EVS complete their cleanliness rounds? (LD.04.01.01 EP 3)

  Yes

  No

  N/A

• JCPH Only: What is the disinfectant type that we use to clean areas? (IC)

  Yes

  No

  N/A

• JGPH Only: When are nursing EOC rounds completed? (IC)

  Yes

  No

  N/A

Staff member #3

• If a patient asks you to notify his/her family or PCP of his/her admission to the hospital, what is your process? (RI.01.02.01)

  Yes

  No

  N/A

• Where do you locate the Safety Data Sheets (SDS) for the chemicals you use in your workspace? Please show me. (EC.02.01.01 EP 11)

  Yes

  No

  N/A

• What are the Instructions for Use (IFUs) or Manufacturers' Instructions for Use (MIFUs)? and where can you access them? (IC.02.02.01-main; TS.03.02.01; WT.04.01.01)

  Yes

  No

  N/A

• Where is the nearest eyewash station? (EC.02.02.01 EP 5)

  Yes

  No

  N/A

• Where would you locate the Preventive Maintenance (PM) date on a piece of medical equipment? (EC.02.04.03 EP 2)

  Yes

  No

  N/A

• What is your process if PM stickers is past due? (EC.02.04.03 EP 2)

  Yes

  No

  N/A

• What is your process if a door does not close all the way or latch? (EC.02.05.01 EP 15-16)

  Yes

  No

  N/A

• What is your process to check for expired supplies? (WT.01.01.01 EP 2)

  Yes

  No

  N/A

• Can tape be used on medical equipment? (IC.02.01.01 EP 1)

  Yes

  No

  N/A

• How do you properly store/secure oxygen E tanks? (EC.02.05.09 EP 12)

  Yes

  No

  N/A

• When does a nurse notify the provider that a patient has been placed into Restraints/Seclusion? (PC.03.05.09)

  Yes

  No

  N/A

• How do you keep PHI secured in your department? (IM.02.01.01 EP 1)

  Yes

  No

  N/A

• How do you secure medications and/or biologicals on your unit? (MM.03.01.01 EP 6)

  Yes

  No

  N/A

• Radiology or OR Only: How do you know lead aprons are checked and are current/ok to use? (EC.02.02.01 EP 7)

  Yes

  No

  N/A

• JGPH Only: When does EVS complete their cleanliness rounds? (LD.04.01.01 EP 3)

  Yes

  No

  N/A

• JCPH Only: What is the disinfectant type that we use to clean areas? (IC)

  Yes

  No

  N/A

• JGPH Only: When are nursing EOC rounds completed? (IC)

  Yes

  No

  N/A

Staff member #4

• If a patient asks you to notify his/her family or PCP of his/her admission to the hospital, what is your process? (RI.01.02.01)

  Yes

  No

  N/A

• Where do you locate the Safety Data Sheets (SDS) for the chemicals you use in your workspace? Please show me. (EC.02.01.01 EP 11)

  Yes

  No

  N/A

• What are the Instructions for Use (IFUs) or Manufacturers' Instructions for Use (MIFUs)? and where can you access them? (IC.02.02.01-main; TS.03.02.01; WT.04.01.01)

  Yes

  No

  N/A

• Where is the nearest eyewash station? (EC.02.02.01 EP 5)

  Yes

  No

  N/A

• Where would you locate the Preventive Maintenance (PM) date on a piece of medical equipment? (EC.02.04.03 EP 2)

  Yes

  No

  N/A

• What is your process if PM stickers is past due? (EC.02.04.03 EP 2)

  Yes

  No

  N/A

• What is your process if a door does not close all the way or latch? (EC.02.05.01 EP 15-16)

  Yes

  No

  N/A

• What is your process to check for expired supplies? (WT.01.01.01 EP 2)

  Yes

  No

  N/A

• Can tape be used on medical equipment? (IC.02.01.01 EP 1)

  Yes

  No

  N/A

• How do you properly store/secure oxygen E tanks? (EC.02.05.09 EP 12)

  Yes

  No

  N/A

• When does a nurse notify the provider that a patient has been placed into Restraints/Seclusion? (PC.03.05.09)

  Yes

  No

  N/A

• How do you keep PHI secured in your department? (IM.02.01.01 EP 1)

  Yes

  No

  N/A

• How do you secure medications and/or biologicals on your unit? (MM.03.01.01 EP 6)

  Yes

  No

  N/A

• Radiology or OR Only: How do you know lead aprons are checked and are current/ok to use? (EC.02.02.01 EP 7)

  Yes

  No

  N/A

• JGPH Only: When does EVS complete their cleanliness rounds? (LD.04.01.01 EP 3)

  Yes

  No

  N/A

• JCPH Only: What is the disinfectant type that we use to clean areas? (IC)

  Yes

  No

  N/A

• JGPH Only: When are nursing EOC rounds completed? (IC)

  Yes

  No

  N/A