INFECTION CONTROL CHECK LIST (WARD)

• Site conducted

  Select

• Ward/Unit

• Conducted on

  Date

• Prepared by

• Location
  Address

1 HAND HYGIENE

• 1.1 Compliance to 5 moments of hand hygiene

  Yes

  No

  N/A

• 1.2 Compliance to 6 steps of hand hygiene

  Yes

  No

  N/A

• 1.3 ABHR at point of care

  Yes

  No

  N/A

• 1.4 Posters of hand hygiene and 5 moments of hand hygiene

  Yes

  No

  N/A

2 NURSING PROCEDURES

• 2.1 Wound dressing: Follow NNA checklist for aseptic wound dressing

  Yes

  No

  N/A

• 2.2 Catheterization

• 2.2.1 Date of insertion documented

  Yes

  No

  N/A

• 2.2.2 Catheter secured properly with plaster

  Yes

  No

  N/A

• 2.2.3 CBD bag not touching the floor and hang below level of bladder

  Yes

  No

  N/A

• 2.3 IV Cannula (IV Line, CV Line)

• 2.3.1 No thrombophlebitis

  Yes

  No

  N/A

• 2.3.2 IV site plaster clean and dry

  Yes

  No

  N/A

• 2.3.3 Date of insertion documented

  Yes

  No

  N/A

• 2.3.4 No post blood transfusion set re-use for IV fluids

  Yes

  No

  N/A

• 2.3.5 Drip stand clean & free from plaster

  Yes

  No

  N/A

3 Personal Protective Equipment (PPE)

• 3.1 Appropriate usage of PPE

  Yes

  No

  N/A

• 3.2 Adequate stock of PPE

  Yes

  No

  N/A

4 DISINFECTANT AND STERILIZATION

• 4.1 Lotions and solutions not expired and labelled properly

  Yes

  No

  N/A

• 4.2 Soaking of instruments/washing of CSSD sets followed procedure steps as per manufacturers

  Yes

  No

  N/A

• 4.3 Soaking tray should be covered

  Yes

  No

  N/A

• 4.4 Item should fully immersed

  Yes

  No

  N/A

• 4.5 There is record of monitoring of date & time of soaking

  Yes

  No

  N/A

• 4.6 Dilution formula is available and follow the correct contact time

  Yes

  No

  N/A

• 4.7 CSSD sets follows FIFO/FEFO

  Yes

  No

  N/A

5 SPILLAGE MANAGEMENT

• 5.1 Spillage flow chart is available

  Yes

  No

  N/A

6 MEDICATION FRIDGE ITEMS

• 6.1 Medication not expired

  Yes

  No

  N/A

• 6.2 Date open documented / labelled properly

  Yes

  No

  N/A

• 6.3 External & internal surface are clean & free from dust

  Yes

  No

  N/A

• 6.4 No food, drinks, specimen/inappropriate item keep in refrigerator

  Yes

  No

  N/A

• 6.5 There is record of temperature monitoring (Temperature 2- 8’C)

  Yes

  No

  N/A

7 ENVIRONMENTAL HYGIENE & HOUSE KEEPING

• 7.1 Floor and sinks are clean

  Yes

  No

  N/A

• 7.2 Equipments clean and not dusty

  Yes

  No

  N/A

• 7.3 All sterile products are stored above floor level

  Yes

  No

  N/A

• 7.4 Treatment & Procedure room are clean & tidy (free from dust)

  Yes

  No

  N/A

• 7.5 Disposable items not reused

  Yes

  No

  N/A

• 7.6 Good ventilation

  Yes

  No

  N/A

• 7.7 Corridor & patient area clean, dry, neat & tidy

  Yes

  No

  N/A

• 7.8 Toilet & bathroom are clean, neat & tidy

  Yes

  No

  N/A

• 7.9 Bedpans, urinal are clean, dry & stored inverted in rakes

  Yes

  No

  N/A

8 MANAGEMENT OF CLINICAL WASTE, SHARPS & LINEN

• 8.1 Sharp bin not more than ¾ full

  Yes

  No

  N/A

• 8.2 No needles, syringe & sharp are protruding from the sharp bin

  Yes

  No

  N/A

• 8.3 Blood taking trolley complete and clean

  Yes

  No

  N/A

• 8.4 Proper segregation of waste

  Yes

  No

  N/A

• 8.5 Placement of bin at the correct place

  Yes

  No

  N/A

9 MEDICAL & OXYGEN EQUIPMENT

• 9.1 All medical equipment is clean and free from dust. Syringe pump, nebulae machine, ECG, cardiac monitor etc

  Yes

  No

  N/A

• 9.2 O2 tubing and Humidifier chamber wash every 24 hours & label with date & time

  Yes

  No

  N/A

• 9.3 O2 tubing, humidifier bottle and nebuliser not in use kept clean and dry

  Yes

  No

  N/A

• 9.4 Used tubing not dangling or touching floor (secured properly)

  Yes

  No

  N/A

• 9.5 O2 Flowmeter outlet covered

  Yes

  No

  N/A

10 TRANSMISSION BASED PRECAUTIONS

• 10.1 Infected patient isolated/cohorted as per policy

  Yes

  No

  N/A

• 10.2 Star signage for contact precaution in placed (bedhead,medication chart, BHT)

  Yes

  No

  N/A

• 10.3 Isolation trolley with isolation box in place

  Yes

  No

  N/A

• 10.4 PPE is wear properly as per policy

  Yes

  No

  N/A

11 ISOLATION ROOM

• 11.1 Isolation room are clean & free from dust

  Yes

  No

  N/A

• 11.2 PPE, linen bag, clinical waste bin are available

  Yes

  No

  N/A

• 11.3 Monitoring of pressure is well recorded as per flow chart (For negative pressure room)

  Yes

  No

  N/A

SIGN OFF

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• Infection Control

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