Audit

there are no environmental risks

Preparation

instruments are opened at point of use

the bracket table is clean

hand hygiene is performed (5 moments)

instruments are gathered

everything is opened in an aseptic manner

blue wrap is present

non-touch technique is applied

Personal Protective Equipment

gown are worn (if high risk procedure)

mask are worn and fitted appropriately

glasses are worn and well fitted

5 moments of hand hygiene is demonstrated

gloves are worn

Procedure

hand hygiene (5 M/Gloves)

non-touch technique is demonstrated

needle are disposed appropriately after use

key parts are separated and protected on the bracket table

bracket table is uncluttered

Type of field is managed correctly

general aseptic field is managed correctly

critical aseptic field is managed correctly

surgical aseptic field is managed correctly (DSU)

Point of use wiping is managed correctly

sharps are disposed appropriately

waste is segregated and disposed appropriately

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.