IC EOC Rounding Tool

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

EMPLOYEE INTERVIEW

• Staff can verbalise where the infection control manual is

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Staff can verbalise steps to take if an injury or exposure occurs

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Staff can locate infection control and employee health contact numbers

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Staff can locate nearest spill kit

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Staff can name and use of appropriate disinfectant and its contact time

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

EQUIPMENT / SUPPLIES

• Linen is covered and stored appropriately <br>

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Expired supplies found gg

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Accu-checks are cleaned and stored appropriately

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Refrigerators are clean and well kept

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Furniture and equipment is in good working condition and able to be disinfected

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Equipment is not stored on the floor

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Clean and dirty supplies are clearly marked and stored in different locations

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• No under sink storagw

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

EVS

• Vents are clear of dust and debris

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Floors are clear of trash and any fluid

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Furniture, equipment, ledges and high areas are free of dust

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• The department is clear of any and all pests

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Waste is discarded in appropriate container

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Waste receptacles are not overflowing

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Curtains are clean and stain/door cree

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Hand washing sink and/or hand disinfectant available for staff use

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Soap, alcohol gel and paper towels are stocked and working properly

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Contact time is being followed for the appropriate disinfectant.

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

GENERAL

• Expired food and drink found in department

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Hand hygiene is bing performed during the appropriate time

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Food and drinks are found only in appropriate areas

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

HAZARDOUS MATERIALS

• Sharp containers are secured and not more than 3/4 full

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Chemicals are labeled and stored appropriately

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Biohazard containers are appropriately labeled

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

ISOLATION

• Appropriate sign is posted

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Isolation cart is available and stocked

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• PPE is being used appropriately by staff members

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Bleach wipes are available for C Diff isolation rooms

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

MEDICATION

• Medications are secured

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Expired medications are found

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Pill crushers and slicers are clean and sanitary

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Hand hygiene is being performed during med pass

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

TEMPERATURE AND HUMIDITY

• Temperature and humidity is logged daily for current month

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• Temperature and humidity are within the normal or stated ranged for current month

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control

• If no, was an appropriate action documented

  Facilities Routine

  Facilities Urgent

  Director

  EVS

  Infection Control