James Rose

EVS-OR Room Turn-Over Audit

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Title Page

Conducted on
Prepared by

Room #
Type of Cleaning Request?
Rate cleanliness of room after case?
Number of EVS staff cleaning the room?
Time nursing entered the room into TeleTacking System as dirty?
Time Patient exited the room?
Time EVS logged into TeleTracking for cleaning?
Time EVS logged out of TeleTracking for completion of between case cleaning?
Did nursing assist in cleaning of room?
Comments:
Total Turn-Over Time?

James Rose

EVS-OR Room Turn-Over Audit

Use this Template

Print as PDF

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