Afif Escheik

Decontamination Receiving Risk Event

An quality audit to review the cases that were picked on a daily basis.

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Title Page

Conducted on
Prepared by
Facility Name
Campus
SPD Location
Campus
- Bellevue
- Elmhurst
- Harlem
- Jacobi
- Kings
- Lincoln
- Metropolitan
- North Central Bronx
- Queens
- South Brooklyn - Coney
- Woodhull
Campus
SPD Location
SPD Location

Decontamination Receiving Risk Event

Name of Tray/Instrument and Number
Instrument /Tray contained no visible gross soil
Instrument/Tray sprayed with pretreatment
Sharps/Disposables Removed
Instruments Restrung
Instruments in correct tray
What trays were affected? (Must have tray names and numbers)
How much time did it take to correct? (In Minutes)
Which department did the Instruments/Trays come from?
- Operating Room
- Labor & Delivery
- Emergency Dept.
- Radiology
- Heart Cath Lab
- Wound Care
- Radiation Therapy
- Gen Surg Physician Offices
- Urology Office
- Pain Management

Afif Escheik

Decontamination Receiving Risk Event

An quality audit to review the cases that were picked on a daily basis.

Use this Template

Print as PDF

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