Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Cleans and disinfects reusable noncritical equipment, nonporous surfaces (mattress pads, pneumatic tourniquet cuffs, sequential stockings cords) after each patient use.

  • Cleans and disinfects high-touch objects after each patient use.

  • Cleans and disinfects operating room table and flat surfaces after the patient has left the room

  • Removes trash and used linen before beginning environmental cleaning.

  • Cleans and disinfects the floors, the lights of the OR, after each surgical invasive procedue

  • Staff member can identify the cleaning products for different equipment (eg. Lights -oxycide, Floors-Ecolab Encompass, surfaces, mayo stand, back tables, beds, cords Alaris pumps-Super Sani Purple top cloths, computer screens, keyboards & monitors-PDI gray top sandi cloths)

  • Staff member knows dwell times for cleaning products such as: Purple top sani-cloths=2 min., Oxycide=3 min., Gray top PDI sani-cloths= 3 min.

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