DBHDD Infection Prevention and Control Rounds

Title Page

A. Medication Rooms/Treatment Room:

1. Refrigerator temperature is between 36-46 degrees F and no items other than medication are present.
2. Items are not stored under the sink.
3. Hand washing sign is over the sink.
4. Hand washing or waterless agent is available
5. Paper towels are available in the dispenser.
6. There are no capped needle containers
7. Counter tops are clean.
8. Cabinets are clean.
9. Floor is clean.
10. No stained or missing ceiling tiles
11. Items are stored 4 inches above floor or moveable.
Additional Comments:

1. Barrier kit easily accessible.
2. Staff knows how to access the Infection Prevention and Control Policy and Attachments.
3. Floor of nurse’s station is clean.
4. Countertops are clean and free of clutter.
5. Shelves are clean and free of clutter.
6. There are no dirty dishes on desks and counters of nurse’s station.
7.True Exposure Protocol Packet available.
8. No stained or missing ceiling tiles.
9. Items are stored 4 inches above floor or moveable.
Additional Comments:

1. Dirty linen containers are located outside door of unit or in soiled holding area on the unit.
15. No stained or missing ceiling tiles.
2. Clean linens are stored neatly on the shelves of the clean linen closets and linen is covered with plastic wrap.
3. There are no dirty dishes/trays in the hallway.
4. Hallway floors are clean and free of clutter.
5. Sharps containers are secured and less than 2/3 full.
6. Dayroom floors are clean and free of clutter.
7. Curtains and upholstery are clean and in good repair.
8. Surfaces in dayroom are clean.
9. Refrigerator temperature is between 35 and 46 degrees F and all food is covered and dated.
10. Sinks are clean.
11. Scoops for ice are stored inside the icemaker/machine or inside a scoop holder which may be mounted outside of the machine.
12. Trashcans are emptied regularly and are free of odor.
13. Floors are clean.
14. Mop water clean/changed properly. Note: The mop water and mop head will be changed at least every three (3) rooms, after mopping each bathroom or each contaminated area, and at least every hour.
16. Items are stored 4 inches above floor or moveable.
Additional Comments:

1. An adequate supply of soap and paper towels is present.
2. Sink and counters are clean and free of clutter.
3. Personal Care Kit items are in personal containers and toothbrushes are stored with a cover.
4. Toilet is clean and free of odor.
5. Toilet paper is available in the holder.
6. Floors are clean and free of clutter.
7. Showers, shower chairs, tubs are clean and in good repair.
8. Shower curtains are clean and not torn.
9. Restrooms are free of dirty towels and clothes.
10. No stained or missing ceiling tiles
11. Items are stored 4 inches above floor or moveable.
Additional Comments:

1. Work area is clean, neat and free of clutter.
2. Staff knows how to access electronic manuals.
3. Hand washing facilities are available with adequate soap, paper towels & waterless gel.
4. No stained or missing ceiling tiles
5. Items are stored 4 inches above floor or moveable.
Additional Comments:

1. Work area is clean, neat and free of clutter.
2. Hand washing facilities are available with adequate soap, paper towels, & waterless gel.
3. Disposable razor blades and other sharps are discarded in secured, impervious container less than 2/3 full.
4. Soiled linen container is covered
5. No stained or missing ceiling tiles.
6. Items are stored 4 inches above floor or moveable.
Additional Comments: