General Workplace Inspection - hospital

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Previous inspection

• Has the last inspection been reviewed?

  Yes

  No

  N/A

• Are there no outstanding actions?

  Yes

  No

  N/A

Patient Safety

Are corridors kept clear to allow adequate space?

• To allow ambulation of patients and visitors to walk safely?

  Yes

  No

  N/A

• To allow carts, wheelchairs and beds to pass with adequate clearance?

  Yes

  No

  N/A

• Are floors clear and slip-resistant?

  Yes

  No

  N/A

Are medications secured and locked?

• Are medication rooms and carts locked when not attended?

  Yes

  No

  N/A

• Are medications secured at all times?

  Yes

  No

  N/A

Fire Safety

• Are the means of egress/exit doors clearly and correctly marked?

  Yes

  No

  N/A

• Exit sign lights working?

  Yes

  No

  N/A

• Clear of debris and equipment?

  Yes

  No

  N/A

• Is equipment all to one side of the hall?

  Yes

  No

  N/A

Do all identified fire extinguisher locations?

• Is the location clearly marked?

  Yes

  No

  N/A

• Have current inspection tags?

  Yes

  No

  N/A

• Are safety seals present?

  Yes

  No

  N/A

• Have 3foot access clearance?

  Yes

  No

  N/A

Are the fire alarm pull stations

• Accessible with 3 foot clearance?

  Yes

  No

  N/A

• In good condition?

  Yes

  No

  N/A

Are combustible materials: (paper,cardboard boxes,linen,waste)

• Stored in proper type of containers?

  Yes

  No

  N/A

• Kept in minimum quantities necessary for daily use?

  Yes

  No

  N/A

• Properly labeled?

  Yes

  No

  N/A

• Kept in a safe designated location?

  Yes

  No

  N/A

Fire Smoke Stair doors:

• Are the doors free of being propped/held/wedged open?

  Yes

  No

  N/A

• Are doorways clear to close?

  Yes

  No

  N/A

• Do fire and stairwell doors latch firmly?

  Yes

  No

  N/A

• Are door interrupters working?

  Yes

  No

  N/A

• No door wedges present?

  Yes

  No

  N/A

• Are items stored at least 18" below sprinkler head?

  Yes

  No

  N/A

• Do patient privacy curtains have 18" net at the top?

  Yes

  No

  N/A

• Are portable space heaters present in patient sleeping areas?

  Yes

  No

  N/A

• No indication of s,oping in the area?

  Yes

  No

  N/A

Safe Environment:

Are the floors / hallways (tile &carpet)

• In good condition?

  Yes

  No

  N/A

• Clean and dry

  Yes

  No

  N/A

• Free from trip/slip/fall hazards?

  Yes

  No

  N/A

• Wet floor signs used

  Yes

  No

  N/A

• Carpet lying flat on floor?

  Yes

  No

  N/A

• There are no wires or cables across walkways?

  Yes

  No

  N/A

Are the walls:

• In good condition?

  Yes

  No

  N/A

• Any exposed wires/cables present?

  Yes

  No

  N/A

• Electrical boxes, outlets, covers in good condition?

  Yes

  No

  N/A

Are ceiling tiles:

• In place and in good condition?

  Yes

  No

  N/A

• Clean free of dirt, mold, and dust?

  Yes

  No

  N/A

• Free of evidence of water staining & dry?

  Yes

  No

  N/A

Are safe / proper infection control practices used by staff?

• Are needle boxes less than 75% full

  Yes

  No

  N/A

• Is clean linen covered?

  Yes

  No

  N/A

• Are clean and dirty linens kept separate?

  Yes

  No

  N/A

• Is medication labeled and dated? (Any outdated items found?)

  Yes

  No

  N/A

• Are refrigerators appropriately labeled?

  Yes

  No

  N/A

• Do refrigerators have current temp logs?

  Yes

  No

  N/A

• Are all cardboard boxes off the floor and no shipping boxes on the unit?

  Yes

  No

  N/A

• Are blood borne pathogen precautions in evidence? (Gloves,masks,gowns, separation of waste)

  Yes

  No

  N/A

• Is PPE readily available and in good condition?

  Yes

  No

  N/A

• Are the areas under the sink free of patient contact items?

  Yes

  No

  N/A

• Are compressed gases stored/ used in this area secured?

  Yes

  No

  N/A

• Is there less than 300 cu ft O2 stored in area? (12 E tanks)

  Yes

  No

  N/A

Hazardous materials and waste:

• Are hazardous chemicals used in this area?

  Yes

  No

  N/A

• Are they stored correctly?

  Yes

  No

  N/A

• Are they disposed of correctly? (Procedures followed)

  Yes

  No

  N/A

SDS

• Can staff explain how to look up an SDS?

  Yes

  No

  N/A

• Can staff describe what info is contained on SDS sheets?

  Yes

  No

  N/A

• Is there a chemical inventory list?

  Yes

  No

  N/A

• Has the list been updated within the past 12 months?

  Yes

  No

  N/A

• Can staff explain the locations of SDS master files?

  Yes

  No

  N/A

Are medical wastes:

• In red biohazard bags / labeled containers?

  Yes

  No

  N/A

• Is pharmaceutical waste in the proper containers?

  Yes

  No

  N/A

• Pharmaceutical waste is secured in the med room?

  Yes

  No

  N/A

• Properly stored and disposed of?

  Yes

  No

  N/A

• Properly separated and segregated?

  Yes

  No

  N/A

Medical equipment

Is there medical equipment in use or used in this area?

• Are inspection tags current?

  Yes

  No

  N/A

• Can staff explain if equipment is current?

  Yes

  No

  N/A

• Is equipment clean and stored properly?

  Yes

  No

  N/A

• Can staff describe training requirements for equipment?

  Yes

  No

  N/A

• Can staff explain emergency procedures for life support equipment?

  Yes

  No

  N/A

Utility systems

Are emergency power outlets:

• Clearly marked?

  Yes

  No

  N/A

• Used for critical equipment only?

  Yes

  No

  N/A

Is there any exposed wiring or electrical panels?

• Are breakers labeled?

  Yes

  No

  N/A

• Are panels kept locked?

  Yes

  No

  N/A

• Outlets, electrical box cover plates aren't damaged or missing?

  Yes

  No

  N/A

Are medical gas zone valves and main valves:

• Are valves marked with identity &locations served?

  Yes

  No

  N/A

• Is the valve access alb and not blocked?

  Yes

  No

  N/A

• Do staff understand who should shut oxygen valves in the case of a fire emergency?

  Yes

  No

  N/A

Security

• Are all employees wearing ID badges in plain view?

  Yes

  No

  N/A

• Can staff explain how to get help in a security emergency?

  Yes

  No

  N/A

• Are protective measures in sensitive areas active & are staff able to explain their role in protecting the patients?

  Yes

  No

  N/A

• Can staff explain their role in a code pink? (If any)

  Yes

  No

  N/A

Emergency operations plan

• Can staff explain their role in the various emergency operations plan?

  Yes

  No

  N/A

Comments

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