Audit

----- EIA -----
EOC

Rooms 3 - 5 oxygen/suction functional and ready for use?

Bays 11 - 13 Oxygen functional and ready for use?

Ice machine clean, functional?

White boards filled out in rooms?

Sink cabinets zip-tied?

No restraints left on stretchers?

No pt info left up on computer screen?

No artificial nails or gel polish on staff?

Accu check controls dated, not expired.

Blanket warmer only has approved items, safety sticker present?

Oxygen tanks properly stored/used.

Two patient identifiers verbally stated whenever meds are given?

Area free of cardboard?

Temperature/Crash Cart Logs Completed?

No expired items on crash cart?

All curtains present, clean?

Percentage of ports capped with a Curos

No Pharm meds left out?

No food or drinks at nurse's station?

Iso patients have sticker on door, tab on wristband?

No used UHS carts (iso or crash) left out?

Cabinets/drawers free of items that don’t belong there

No meds left out?

IV carts clean, free of items that don't belong in them?

IV Carts found locked?

IV Carts free of expired items?

IV Cart handles intact?

No tape or stickers on PC monitors, walls, floors, etc?

Nothing in front of fire extinguishers?

Sharps containers no more than ¾ full, none broken?

Linen not more than 3/4 full?

Shandswiches not expired?

Airway bags/crash carts have dated green tag?

All Pyxis machines clutter free on top?

Red bio cans clean, not overflowing, functional?

No clean items in dirty rooms?

No dirty items in clean rooms?

No patient belongings left out?

No gloves worn outside of patient vicinity.

Broken stretchers/damaged mattresses labeled for pickup?

Pt fridges clear of non-pt food/expired food

Staff/patient fridges don't need defrosting?

Labs/cultures labeled at bedside?

Red and Blue bins found closed?

No sterile packaging found compromised?

No sharps left out?

Hand hygiene before/after pt contact, after gloves off.

Product up off the floor?

No doors improperly propped open?

Alere cartridges individually labeled?

No gross infractions found?

All call bells in place?

Pharm Room checked?

EKG Room checked?

De-clutter nurse station counter storage bin.

EVS

No dust in areas?

No odor in dirty rooms?

Floors don't need mopping, sweeping?

Bathrooms clean?

Trash not overflowing?

Facilities

Lights all working, in good condition?

No ceiling tiles need replacing?

No paint chipping, holes need patching?

----- ECC -----
EOC

Urine cups, urinals, bedpans, diapers, chucks stocked?

No restraints left on stretchers?

No pt info left up on computer screen?

No artificial nails or gel polish on staff?

No linen on shelf nearest floor?

Accu check controls dated, not expired.

Oxygen tanks properly stored/used.

Two patient identifiers verbally stated whenever meds are given?

Area free of cardboard?

Yellow bin de-cluttered, free of old blood?

Yellow bin tubes labeled, no labels on bag exterior?

Temperature Logs Completed?

All curtains present, clean?

Percentage of ports capped with a Curos

No Pharm meds left out?

No food or drinks at nurse's station?

No used UHS carts (iso or crash) left out?

Iso patients have sticker on door, tab on wristband?

Cabinets/drawers free of items that don’t belong there

No meds left out?

IV carts locked?

IV Carts free of expired items?

IV Cart handles intact?

IV carts clean, free of items that don't belong in them?

No tape or stickers on PC monitors, walls, floors, etc?

Nothing in front of fire extinguishers?

Sharps containers no more than ¾ full, none broken?

Linen not more than 3/4 full?

Shandswiches not expired?

Airway bags/crash carts have dated green tag?

All Pyxis machines clutter free on top?

Red bio cans clean, not overflowing, functional?

No clean items in dirty rooms?

No dirty items in clean rooms?

No patient belongings left out?

No gloves worn outside of patient vicinity.

Broken stretchers/damaged mattresses labeled for pickup?

Pt fridges clear of non-pt food/expired food

Staff/patient fridges don't need defrosting?

Labs/cultures labeled at bedside?

Alere machines clean, free of dried blood?

Red and Blue bins found closed?

No sterile packaging found compromised?

No sharps left out?

Hand hygiene before/after pt contact, after gloves off.

Product up off the floor?

No doors improperly propped open?

Alere cartridges individually labeled?

4x4s available at Alere station?

Culture bottles labeled with "fill to" line?

No gross infractions found?

No meds left out in attending office?

No meds left out in Dr Workroom?

EVS

No dust in areas?

No odor in dirty rooms?

Floors don't need mopping, sweeping?

Bathrooms clean?

Trash not overflowing?

Facilities

Lights all working, in good condition?

No ceiling tiles need replacing?

No paint chipping, holes need patching?

----- Resus -----
EOC

No restraints left on stretchers?

No pt info left up on computer screen?

No artificial nails or gel polish on staff?

Accu check controls dated, not expired.

Blanket warmer only has approved items

Fluid warmer has no expired fluids?

Fluid fridge stocked, has no expired fluids?

Oxygen tanks properly stored/used.

Two patient identifiers verbally stated whenever meds are given?

Area free of cardboard?

Temperature Logs Completed?

All curtains present, clean?

Percentage of ports capped with a Curos

No Pharm meds left out?

No food or drinks at nurse's station?

Iso patients have sticker on door, tab on wristband?

No used UHS carts (iso or crash) left out?

Cabinets/drawers free of items that don’t belong there

No meds left out?

IV carts clean, free of items that don't belong in them?

IV Carts free of expired items?

IV Cart handles intact?

IV Carts locked?

No tape or stickers on PC monitors, walls, floors, etc?

Nothing in front of fire extinguishers?

Sharps containers no more than ¾ full, none broken?

Linen not more than 3/4 full?

Airway bags/crash carts have dated green tag?

All Pyxis machines clutter free on top?

Red bio cans clean, not overflowing, functional?

No dirty items in clean rooms?

No patient belongings left out?

No gloves worn outside of patient vicinity.

Broken stretchers/damaged mattresses labeled for pickup?

Staff/patient fridges don't need defrosting?

Labs/cultures labeled at bedside?

Red and Blue bins found closed?

No sterile packaging found compromised?

No sharps left out?

Hand hygiene before/after pt contact, after gloves off.

Product up off the floor?

No doors improperly propped open?

Percentage Resus shelves stocked

Brochoscopes cleaned less than 6 days ago?

SPD Cart utilized appropriately?

Extra cords in clear ziploc bags?

Nothing in front of O2 shutoff valves?

No gross infractions found?

EVS

No dust in areas?

Floors don't need mopping, sweeping?

Trash not overflowing?

Facilities

Lights all working, in good condition?

No ceiling tiles need replacing?

No paint chipping, holes need patching?

----- Trauma -----
EOC

No restraints left on stretchers?

No pt info left up on computer screen?

No artificial nails or gel polish on staff?

Accu check controls dated, not expired.

Blanket warmer only has approved items

Fluid warmer stocked, has no expired fluids?

Oxygen tanks properly stored/used.

Two patient identifiers verbally stated whenever meds are given?

Area free of cardboard?

Temperature/Lifepak Logs Completed?

All curtains present, clean?

Percentage of ports capped with a Curos

No Pharm meds left out?

No food or drinks at nurse's station?

Iso patients have sticker on door, tab on wristband?

No used UHS carts (iso or crash) left out?

Cabinets/drawers free of items that don’t belong there

No meds left out?

No tape or stickers on PC monitors, walls, floors, etc?

Nothing in front of fire extinguishers?

Sharps containers no more than ¾ full, none broken?

Linen not more than 3/4 full?

Shandswiches not expired?

Airway bags/crash carts have dated green tag?

All Pyxis machines clutter free on top?

Red bio cans clean, not overflowing, functional?

No clean items in dirty rooms?

No dirty items in clean rooms?

Urine strips have QC label?

Urine preg cartridges have QC label?

Urine put into tubes and dated/timed?

Clinitek Calibration Bar clean?

No patient belongings left out?

No gloves worn outside of patient vicinity.

Broken stretchers/damaged mattresses labeled for pickup?

Pt fridges clear of non-pt food/expired food

Staff/patient fridges don't need defrosting?

Microwave clean?

Labs/cultures labeled at bedside?

Red and Blue bins found closed?

No sterile packaging found compromised?

No sharps left out?

Hand hygiene before/after pt contact, after gloves off.

Product up off the floor?

No doors improperly propped open?

Extra cords in clear ziploc bags?

No gross infractions found?

De-Clutter Ortho Cart

De-Clutter Ortho Cabinet

EVS

Not more than 2 big red bins in Dirty Room?

Trash not overflowing?

No dust in areas?

No odor in dirty rooms?

Floors don't need mopping, sweeping?

Bathrooms clean?

Facilities

Lights all working, in good condition?

No ceiling tiles need replacing?

No paint chipping, holes need patching?

----- Peds -----
EOC

No restraints left on stretchers?

No pt info left up on computer screen?

No artificial nails or gel polish on staff?

Accu check controls dated, not expired.

Blanket warmer only has approved items

Oxygen tanks properly stored/used.

Two patient identifiers verbally stated whenever meds are given?

Area free of cardboard?

Temperature/Lifepak Logs Completed?

All curtains present, clean?

Percentage of ports capped with a Curos

No Pharm meds left out?

No food or drinks at nurse's station?

Iso patients have sticker on door, tab on wristband?

No used UHS carts (iso or crash) left out?

Cabinets/drawers free of items that don’t belong there

No meds left out?

IV carts clean, free of items that don't belong in them?

IV Carts locked?

IV Carts free of expired items?

IV Cart handles intact?

No tape or stickers on PC monitors, walls, floors, etc?

Nothing in front of fire extinguishers?

Sharps containers no more than ¾ full, none broken?

Linen not more than 3/4 full?

Airway bags/crash carts have dated green tag?

All Pyxis machines clutter free on top?

Red bio cans clean, not overflowing, functional?

No clean items in dirty rooms?

No dirty items in clean rooms?

Urine preg cartridges have QC label?

Urine strips have QC label?

Urine put into tubes and dated/timed?

Clinitek Calibration Bar clean?

No patient belongings left out?

No gloves worn outside of patient vicinity.

Broken stretchers/damaged mattresses labeled for pickup?

Pt fridges clear of non-pt food/expired food

Staff/patient fridges don't need defrosting?

Labs/cultures labeled at bedside?

Red and Blue bins found closed?

No sterile packaging found compromised?

No sharps left out?

Hand hygiene before/after pt contact, after gloves off.

Product up off the floor?

No doors improperly propped open?

Outlet covers in sockets?

Ice machine clean, functional?

Nothing on top of lockers?

No gross infractions found?

De-clutter supply room.

De-clutter lab bin at nurse station

EVS

No dust in areas?

No odor in dirty rooms?

Floors don't need mopping, sweeping?

Bathrooms clean?

Trash not overflowing?

Facilities

Lights all working, in good condition?

No ceiling tiles need replacing?

No paint chipping, holes need patching?

----- CDU -----
EOC

No restraints left on stretchers?

No pt info left up on computer screen?

No artificial nails or gel polish on staff?

Accu check controls dated, not expired.

Oxygen tanks properly stored/used.

Two patient identifiers verbally stated whenever meds are given?

Area free of cardboard?

Temperature/Crash Cart Logs Completed?

No expired items on crash cart?

All curtains present, clean?

Percentage of ports capped with a Curos

No Pharm meds left out?

No food or drinks at nurse's station?

Iso patients have sticker on door, tab on wristband?

No used UHS carts (iso or crash) left out?

Cabinets/drawers free of items that don’t belong there

No meds left out?

IV carts clean, free of items that don't belong in them?

IV Carts locked?

IV Carts free of expired items?

IV Cart handles intact?

No tape or stickers on PC monitors, walls, floors, etc?

Nothing in front of fire extinguishers?

Sharps containers no more than ¾ full, none broken?

Linen not more than 3/4 full?

Shandswiches not expired?

Airway bags/crash carts have dated green tag?

All Pyxis machines clutter free on top?

Red bio cans clean, not overflowing, functional?

No clean items in dirty rooms?

No dirty items in clean rooms?

Urine preg cartridges have QC label?

Urine strips have QC label?

Urine put into tubes and dated/timed?

Clinitek Calibration Bar clean?

No patient belongings left out?

No gloves worn outside of patient vicinity.

Broken stretchers/damaged mattresses labeled for pickup?

Pt fridges clear of non-pt food/expired food

Staff/patient fridges don't need defrosting?

Labs/cultures labeled at bedside?

Red and Blue bins found closed?

No sterile packaging found compromised?

No sharps left out?

Hand hygiene before/after pt contact, after gloves off.

Product up off the floor?

No doors improperly propped open?

Alere cartridges individually labeled?

Culture bottles labeled with "fill to" line?

Iso Room - Cart free of items that shouldn't be there?

Iso Room - Negative Pressure Alarms functional?

Room 10 cart satisfactory?

No gross infractions found?

Nothing in stairwell behind CDU?

Microwave clean?

Check Bay 1 drawers.

Check Bay 4 drawers.

Check and de-clutter back nurse station.

De-clutter Alere alcove.

EVS

No dust in areas?

No odor in dirty rooms?

Floors don't need mopping, sweeping?

Bathrooms clean?

Trash not overflowing?

Facilities

No ceiling tiles need replacing?

No paint chipping, holes need patching?

----- Flex, Triage, Waiting Room -----
EOC

Triage Cabinets/drawers satisfactory?

Quick Reg cabinets/drawers satisfactory?

Waiting Room bathroom satisfactory?

No restraints left on stretchers?

No pt info left up on computer screen?

No artificial nails or gel polish on staff?

Accu check controls dated, not expired.

Oxygen tanks properly stored/used.

Two patient identifiers verbally stated whenever meds are given?

Area free of cardboard?

Temperature/Crash Cart Logs Completed?

No expired items on crash cart?

All curtains present, clean?

Percentage of ports capped with a Curos

No Pharm meds left out?

No food or drinks at nurse's station?

Iso patients have sticker on door, tab on wristband?

No used UHS carts (iso or crash) left out?

Cabinets/drawers free of items that don’t belong there

No meds left out?

IV carts clean, free of items that don't belong in them?

IV Carts locked?

IV Carts free of expired items?

IV Cart handles intact?

No tape or stickers on PC monitors, walls, floors, etc?

Nothing in front of fire extinguishers?

Sharps containers no more than ¾ full, none broken?

Linen not more than 3/4 full?

Shandswiches not expired?

Airway bags/crash carts have dated green tag?

All Pyxis machines clutter free on top?

Red bio cans clean, not overflowing, functional?

No clean items in dirty rooms?

No dirty items in clean rooms?

Urine preg cartridges have QC label?

Urine strips have QC label?

Urine put into tubes and dated/timed?

Clinitek Calibration Bar clean?

No patient belongings left out?

No gloves worn outside of patient vicinity.

Broken stretchers/damaged mattresses labeled for pickup?

Pt fridges clear of non-pt food/expired food

Staff/patient fridges don't need defrosting?

Labs/cultures labeled at bedside?

Red and Blue bins found closed?

No sterile packaging found compromised?

No sharps left out?

Hand hygiene before/after pt contact, after gloves off.

Product up off the floor?

No doors improperly propped open?

Alere cartridges individually labeled?

Trophon logbook properly filled out?

Trophon supplies stocked?

Trophon in working order?

Culture bottles labeled with "fill to" line?

Triage EKG Machine Cables Clean?

Triage wheelchairs not blocking O2 shutoff?

Eye room cart satisfactory?

Room 5 cart satisfactory?

Room 12 cart satisfactory?

Cubby cart satisfactory?

No gross infractions found?

De-clutter Flex nurse station cabinets/drawers.

De-clutter Rainbow Room.

De-clutter Eye Room cart.

De-clutter Room 5 cart.

De-clutter Room 12 cart.

De-clutter ortho cart.

EVS

No bugs in Triage light covers?

No dust in areas?

No odor in dirty rooms?

Floors don't need mopping, sweeping?

Bathrooms clean?

Trash not overflowing?

Facilities

Lights all working, in good condition?

No ceiling tiles need replacing?

No paint chipping, holes need patching?

----- Special Rooms -----

Peds back locker area clutter free, exit not blocked?

Peds specialty supply room neat?

Decon Shower Room clean?

Air Room clean, stocked?

Viewing Room clean?

Resus Quiet Room clean?

Both Trauma Quiet Rooms clean, TV working?

Forms Room clean?

Peds fellows office - Items off of floor?

No gross infractions found?

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.