Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location

ERNA Environmental Safety Inspection

Patient Confidentiality

  • No patient personal information in public; Station and Computer

  • Patient is covered during transportation

Infection Control

  • Regular and infectious waste disposed in appropriate containers. Not overfilled

  • Sharp containers should be tightly closed/sealed at 3/4 full

  • Sharps containers present in appropriate locations

  • Hand rub dispenser in every clinical room, patient waiting areas, near the elevators and at each sink available

  • Is there adequate PPE available?

  • Are people trained in the use of PPE?

  • Items for CSSD are clean and stacked

  • Treatment trolleys are clean and organized

  • All the used linens and hamper bags are stored in soiled utility room

  • Food is stored and eaten in designated places

  • Spill kit available and updated


  • Patient bathrooms have non-slippery surface. Door can be accessed if locked

  • Is adequate lighting in toilet?

  • Is the floor/area free from water?

  • Are doors locks are working?

  • Female and male toilet signs are clear?

  • Waiting areas are separately identified with male and female and organized

Store Room

  • Each nursing area is to make a list of required stock items by description and code, required levels of stock to be held and minimum levels for re-ordering

  • Monitor supply levels and order/re-order as indicated by need or stock level

  • The separation of sterile and non-sterile items

  • Eliminating unnecessary boxes and wrappings

  • Keeping top items 50 cm from ceiling

  • Ensuring that there is a heat/smoke detector and sprinkler

  • Ensuring staff are aware of the location of the nearest fire extinguisher

  • Separate items kept in separate labelled containers or shelf space

  • Heavy items at waist height

  • Fluids on lower shelves

  • No boxes/items stored on the floor

  • Use of easy clean, dust free containers

  • Ensuring shelves and racks are sturdy and in good condition

  • Stacking items on a flat base

  • Rotating supplies so that the most recently received supplies are stored behind new stock and thereby ensure use of in-date items from front first

  • Not hoarding, hiding and keeping a surplus of supplies

  • Stock list displayed at all items for that storeroom

  • List identified with Non-stock item

  • Each item has shelf or container, label with minimum and maximum level weekly

  • No items that are expired or have an expiry date less than 3 months

  • No condemned/non-operational items in store

  • Store Room temperature and humidity

MSDS Checklist

  • MSDS folder available in the area

  • MSDS folder arranged based on table of contents

  • MSDS list updated annually (inventory list) and MSDS sheets are updated in the folder

  • MSDS stocks should be maintained and updated with Minimum and maximum level on weekly basis

  • List of staff who have competency checkoff

  • CPP: Emergency Hazardous Material Spill Management updated in the folder

  • PPE must be available in the MSDS area

  • HAZMAT area must be separated from other areas of the facility

  • Proper labeling according to hazard rating classification.(Diamond sticker)

  • Safety (officer) contact number visible for any suspected or witnessed release of a hazardous material to the environment

Linen (DPP: 30501 /125/30 Ns Patient Linen Management – Nurses Role)

  • A minimum/maximum level for linen requirement per unit is established and should be adhered to

  • Fresh/clean linen is to be stored separate from dirty/used linen

  • Clean linen store is to be secured and preferably locked

  • Problems with amounts, availability or quality are to be documented on a Linen Problem log and followed-up

  • Daily linen monitoring sheet updated and completed

Medication (DPP: 30501-106-30 NS Medication Management – Ordering and Storage)

  • Narcotic cupboard double locked

  • Expiry date of stock (included in medication fridge) noted every week

  • Medication room temperature and humidity are monitored and recorded

  • Medication refrigerator temperature maintained 2 to 8 degree °C and recorded

  • No food etc in medication fridge

  • Medication storage areas (room and cart) locked (except when in use)

  • Cassettes are properly labelled with the name of medication and expiry date

  • Medication preparation area is clean, good lighting and closed

  • Updated stock medication list

  • Drug Formulary

  • Approved Abbreviations list /Floor Stock medication policy available

  • Externally and internally used products separated

  • Any product used on patient (external/internal) to be labelled with date when opened

  • Proper removal of medication waste

  • LASA and HAM poster updated.

Refrigerators (DPP:0501-034-1432 NS Food and Medication Storage In Unit/Ward Refrigerators)

  • Food refrigerator temperatures per shift maintained 0-5 °C and recorded

In the event when the refrigerator temp goes beyond or below prescribed temp:

  • An action was taken to correct the malfunction (notify Maintenance Dept.)

  • Foods transferred to another refrigerator

  • Food is stored and eaten in designated places

  • All food placed in refrigerators must be labelled with the patient/staff name and dated 24 hours

  • Any food not stored as per this DPP will be removed from the refrigerator and discarded


  • Lockers and cabinets clean

  • Walls, floors, furniture, pantry clean

  • Cleaning chemicals in product containers with label

  • Nothing under the sink

  • No unapproved cleaning solutions (e.g., not mentioned in the List of Hazmat)

  • Janitor room is locked

  • No housekeeping carts left unattended and keep it in proper place

Medical Equipment

  • Clinical Equipment (Biomed): Clean

  • All equipment has label

  • Last service date (PPM)

  • Next service date (PPM)

  • Next service date not passed

  • Tag if out of order equipment

  • Non-operational equipment labelled

  • Manufacturer's instructions available

  • List of biomedical equipment inventory is accessible

  • Battery log sheet available with updated data

  • Stretchers with straps or side rails, wheelchairs with straps

  • Oxygen tanks are stored in appropriate holders

  • Keep oxygen tank out of entrance ways and walkways

  • Empty cylinders separate from full

  • Daily room check list is updated and maintained


  • Control solutions labelled with date of opening and in date

  • POCT Consumables stored in accordance to PCLM recommendations

  • QC done and results recorded daily

  • POCT (Glucose, urine, pregnancy test, etc) competencies list is updated

Emergency Contacts

  • Station/telephones (either poster or label on phone): Emergency: X 22222

  • Color code emergencies posted

  • Radiation safety officer name and contact details

  • KFMC safety officer name and contact details


  • Reference manuals;

  • Read and sign folder (Polices updated)

  • Infection control Manual

  • Disaster plans and manuals

  • Safety/Equipment manual

  • Lab guidelines

  • Quality Board – Location/Contents

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.