Information
-
Audit Title
-
Document No.
-
Client / Site
-
Conducted on
-
Prepared by
-
Location
-
Personnel
Cath Lab 1
-
Procedure room surface counters, cabinets, and all surfaces are clean and free of dust.
-
Procedure room furniture, metal tables, and carts are clean and dust free.
-
Procedural room lights are clean and dust free.
-
Procedure cart/bed is clean and free of dust, blood or body fluids.
-
Procedure room booms, cords, and hoses are free of dust, blood or other fluids/soiling.
-
The procedural floor is clean and free of soiling or blood and body fluids.
-
Procedural room trash and biohazardous waste has been removed and disposed of properly.
-
All soiled linen has been removed from procedural room.
Cath Lab 2
-
Procedure room surface counters, cabinets, and all surfaces are clean and free of dust.
-
Procedure room furniture, metal tables, and carts are clean and dust free.
-
Procedural room lights are clean and dust free.
-
Procedure cart/bed is clean and free of dust, blood or body fluids.
-
Procedure room booms, cords, and hoses are free of dust, blood or other fluids/soiling.
-
The procedural floor is clean and free of soiling or blood and body fluids.
-
Procedural room trash and biohazardous waste has been removed and disposed of properly.
-
All soiled linen has been removed from procedural room.
Cath Lab 3
-
Procedure room surface counters, cabinets, and all surfaces are clean and free of dust.
-
Procedure room furniture, metal tables, and carts are clean and dust free.
-
Procedural room lights are clean and dust free.
-
Procedure cart/bed is clean and free of dust, blood or body fluids.
-
Procedure room booms, cords, and hoses are free of dust, blood or other fluids/soiling.
-
The procedural floor is clean and free of soiling or blood and body fluids.
-
Procedural room trash and biohazardous waste has been removed and disposed of properly.
-
All soiled linen has been removed from procedural room.
Cath Lab 4
-
Procedure room surface counters, cabinets, and all surfaces are clean and free of dust.
-
Procedure room furniture, metal tables, and carts are clean and dust free.
-
Procedural room lights are clean and dust free.
-
Procedure cart/bed is clean and free of dust, blood or body fluids.
-
Procedure room booms, cords, and hoses are free of dust, blood or other fluids/soiling.
-
The procedural floor is clean and free of soiling or blood and body fluids.
-
Procedural room trash and biohazardous waste has been removed and disposed of properly.
-
All soiled linen has been removed from procedural room.