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  • Clinic

  • Units

  • Units

  • Types of Staff Interviewed (RN, Tech, EVS, Pharmacist, etc.)

AHS Rounds

EOC Exits & Egress; Medication Room

  • All Staff must wear name badges with photo ID visible above waist

  • Egress is clear. Exit doors are not blocked and clear of clutter

  • Hallways clear with all equipment parked on one side or in alcoves

  • Fire rated doors must latch & close properly

  • No flammable items on fire rated doors

  • Nothing in front of medical gas valves, fire extinguishers or pull stations

  • Nothing stored under sinks throughout unit

  • No doorstops used or doors propped open

  • No overfilled sharps containers throughout the unit (replace when ¾ full)

  • Pt information (white board, WOWs & Chart) secured to ensure privacy

  • No food or beverages in patient care areas or nurse’s stations

  • All Pt. equipment labeled with clinical engineering sticker & current PMs

  • Overall cleanliness of unit (floors, walls, clutter, dust)

  • No unattended meds on Pyxis, WOWs, or throughout the unit

  • All insulin or multi-use vials are dated w/discard date in 28 days

  • Med Room: Med Room locked with access for authorized personnel only

  • Med Room: Med Prep areas are clean, uncluttered and separated from other areas

  • Pill cutters are individual use only. Must be labeled with patient name

  • Medication refrigerator and freezer temperatures logged and documented daily

  • Med Room check for expired medications and supplies

Crash Cart, Waived Testing and Infection Control Practices:

  • Crash Cart: Defibrillator is plugged in.

  • Crash Cart tidy and clean. No dust or excessive supplies on crash carts

  • Crash cart logs and Defibrillator check documented daily. Lock is intact.

  • Crash Cart: Check for expired supplies

  • Crash Cart leads are closed and sealed in their original packages

  • Infection Prevention: Contact Precaution sign posted and isolation cart placed outside of room

  • Waived Testing: Glucometer cleaned. Controls and Strips dated w/date opened/expiration date: Toss after 90 days

  • Hand gel stocked in all dispensers

  • No gloves, booties, hanging face masks while in hallway or public areas

  • No open Sani-Cloth containers

  • Hand hygiene performed when staff entering & exiting patient rooms

Patient Pantry/Kitchen; Clean and Soiled Utility Rooms ( C and S)

  • Patient Pantry: Patient food must be labeled with Pt. name and date

  • Patient Pantry: No staff food to be stored in patient refrigerator

  • Patient Pantry: Refrigerator temp checked daily & documented daily by dietary services

  • C: Linen carts must be covered and have solid bottoms throughout the unit

  • C: No supplies stored on the floor. Must be on pallets or wire shelving with solid bottom

  • C: No corrugated shipping boxes. Remove immediately

  • C: O2 tanks are stored upright in the holder. Full and empty O2 tanks are separated with signage

  • C: Check for expired medications and or supplies throughout the unit

  • C & S: No supplies stored within 18 inches from the bottom of the sprinkler head

  • S: No clean supplies or clean equipment to be stored in the soiled utility room

  • S: No storage of patient personal belongings

  • S: Floors are clutter free, allowing access to sink, hopper, and door

  • S: Approved enzymatic gel/ instrument cleaning supplies in room (if applicable)

  • S: All biohazard, pharmaceuticals, garbage containers must be clearly labeled and covered with a lid

  • S: Equipment requiring cleaning or services must be clearly marked

Best Practices and Opportunities for Improvement:

  • Best Practices Noted on the Unit:

  • Opportunities for Improvement Identified on the Unit


  • Was any Service Recovery required? If yes, please explain:

  • Please share any Staff Recognition:

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