Beach Road Surgery & Skin Clinic Infection Control Audit

• Beach Road Surgery & Skin Clinic

  Select

• Conducted on

  Date

• Prepared by

Beach Road Surgery and Skin Clinic

Sterilisation and Cleaning of Equipment

• Signage is visible

  Yes

  No

  N/A

• Record book is up to date

  Yes

  No

  N/A

• Vaccum test is completed weekly

  Yes

  No

  N/A

• Lead pencil test is completed weekly

  Yes

  No

  N/A

• Packing equipment is kept in cupboard

  Yes

  No

  N/A

• All successful sterilisation is documented

  Yes

  No

  N/A

• Equipment is signed and dated

  Yes

  No

  N/A

• Used equipment is logged in Dr's diary

  Yes

  No

  N/A

• Microfibre cloths are kept clean

  Yes

  No

  N/A

• Benches are kept clean and wiped down prior use

  Yes

  No

  N/A

• Clean/dirty areas are clearly labelled e.g. sink

  Yes

  No

  N/A

• All equipment is packed properly

  Yes

  No

  N/A

• PPE is used and available

  Yes

  No

  N/A

• Silver dishes are clean correctly after use

  Yes

  No

  N/A

• Disinfectant is available and kept up to stock

  Yes

  No

  N/A

Employee Hand Hygiene Compliance

• Employees Monitored

  Yes

  No

  N/A

Hand Hygiene

• Sinks for hand hygiene are well stocked?

  Yes

  No

  N/A

• Sinks are available in all areas as needed?

  Yes

  No

  N/A

• Alcohol hand rubs are well stocked?

  Yes

  No

  N/A

• Alcohol hand rubs are available in patient's rooms?

  Yes

  No

  N/A

• Placement of alcohol hand rubs is compliant with safety?

  Yes

  No

  N/A

• Hand washing/hand hygiene is performed between patients?

  Yes

  No

  N/A

• Hand Hygiene reminder posters present?

  Yes

  No

  N/A

• Sink storage area empty and clean?

  Yes

  No

  N/A

• Thrash cans or waste basket are not overfilled or overflowing?

  Yes

  No

  N/A

• Ceiling tiles are not stained or wet?

  Yes

  No

  N/A

• Floors are clean?

  Yes

  No

  N/A

• Supplies are stored at least 6 inches off of the floor?

  Yes

  No

  N/A

• Air intake vents and diffusers are clean?

  Yes

  No

  N/A

• Is this section free of additional findings?

  Yes

  No

  N/A

Practice Rooms

• Clean Utility / Central Supply / Storage

  Yes

  No

  N/A

• Horizontal surfaces are clean?

  Yes

  No

  N/A

• Thrash cans or waste basket are not overfilled or overflowing?

  Yes

  No

  N/A

• Hand hygiene products are available?

  Yes

  No

  N/A

• Soap and paper towels are available in each room?

  Yes

  No

  N/A

• PPE's are available as needed?

  Yes

  No

  N/A

• Patient equipment is clean?

  Yes

  No

  N/A

• No visible soil on vertical surfaces?

  Yes

  No

  N/A

• Ceiling tiles are not discolored, wet, missing, or damaged?

  Yes

  No

  N/A

• Air intake vents and diffusers are clean?

  Yes

  No

  N/A

• Furniture are without tears or wear?

  Yes

  No

  N/A

• Beds are cleaned and covered with disposable protectors?

  Yes

  No

  N/A

• Floors are clean?

  Yes

  No

  N/A

• Sharp containers are no more than 3/4 full?

  Yes

  No

  N/A

• Dust not found in high places?

  Yes

  No

  N/A

• General area is dust free?

  Yes

  No

  N/A

• There is no evidence of pest present?

  Yes

  No

  N/A

• No needles, syringes, medications within reach of the patient?

  Yes

  No

  N/A

• No signs of mildew or mold present?

  Yes

  No

  N/A

• Is this section free of additional findings?

  Yes

  No

  N/A

Employee Kitchen / Breakroom

• Floors and walls clean?

  Yes

  No

  N/A

• Horizontal and vertical surfaces are clean?

  Yes

  No

  N/A

• Microwave oven clean?

  Yes

  No

  N/A

• Refrigerator clean and thawed of ice?

  Yes

  No

  N/A

• Under sink clean and without storage?

  Yes

  No

  N/A

• Employee food labeled and dated?

  Yes

  No

  N/A

• Is this section free of additional findings?

  Yes

  No

  N/A

Nurse's Room

• Unit/area generally clean (without dust, clutter or debris)?

  Yes

  No

  N/A

• Medication, specimens, and vaccinations are handled appropriately?

  Yes

  No

  N/A

• Biohazard trash is segregated from regular trash?

  Yes

  No

  N/A

• Needles and syringes are disposed of properly?

  Yes

  No

  N/A

• Out of date supplies are not present?

  Yes

  No

  N/A

• Infectious waste in red bag or container?

  Yes

  No

  N/A

• Clean items are not stored in soiled utility room?

  Yes

  No

  N/A

• Ceiling tiles are not discolored/ wet/ missing / damaged?

  Yes

  No

  N/A

• Nothing is stored under the sink and there is no sign of leaks?

  Yes

  No

  N/A

• Halls are uncluttered?

  Yes

  No

  N/A

• Respiratory hygiene available?

  Yes

  No

  N/A

• Trash basket are not overflowing?

  Yes

  No

  N/A

• No personal lotion use

  Yes

  No

  N/A

• There are no expired products found

  Yes

  No

  N/A

• Is this section free of additional findings?

  Yes

  No

  N/A

• Monthly checks are completed and recorded

  Yes

  No

  N/A

• Defibrillator checked monthly

  Yes

  No

  N/A

• Temperature checked BID for vaccine / medication storage?

  Yes

  No

  N/A

• Daily refrigerators checks with corrective actions as needed?

  Yes

  No

  N/A

• Glucose meter strips dated

  Yes

  No

  N/A

• Is this section free of additional findings

  Yes

  No

  N/A

Employee General Knowledge

• Employees know the procedure for blood exposure?

  Yes

  No

  N/A

• Personnel can locate their Infection Control Manual?

  Yes

  No

  N/A

• Personnel can locate their Exposure Control Plan?

  Yes

  No

  N/A

• Personnel can locate the spill kit?

  Yes

  No

  N/A

• Employees can state the WHO's 5 moments of Hand Hygiene

  Yes

  No

  N/A

• Dust not found in high places?

  Yes

  No

  N/A

• Is this section free of additional findings?

  Yes

  No

  N/A

Bathroom

• Toilet/Sink clean?

  Yes

  No

  N/A

• clean and orderly?

  Yes

  No

  N/A

• Signage up and visible

  Yes

  No

  N/A

• Hand sanitizer/soap is available

  Yes

  No

  N/A

• Paper towel is available

  Yes

  No

  N/A

• Walls and floor are clean?

  Yes

  No

  N/A

• Ceiling tiles are not discolored/ wet/ missing / damaged?

  Yes

  No

  N/A

• Dust not found in high places?

  Yes

  No

  N/A

• Is this section free of additional findings?

  Yes

  No

  N/A

General Areas

• Cleaning is attended to daily and documented on checklist

  Yes

  No

  N/A

• Furniture has no wear and tear, is clean

  Yes

  No

  N/A

• Cleaners attend to surgery when required

  Yes

  No

  N/A

• Dehumifier is working and maintained

  Yes

  No

  N/A

• Sanitizers are available for clients when entering practice

  Yes

  No

  N/A

• Face masks are worn in areas

  Yes

  No

  N/A

• Signage is up and visible for infection control

  Yes

  No

  N/A

Completion

• Additional Comments

• Surveyor's Name and Signature shontae giles

  Sign

• 10.10.2022 12:18 AEDT

  Yes

  No

  N/A

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