Infection Control (IC) EOC Checklist

IC 1. Flooring surfaces are:▪ Intact▪ Undamaged▪ Clean and free of slip and trip hazards▪ Wet floor signs are used appropriately

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 2. Ceiling surfaces are:▪ Intact▪ Undamaged▪ Clean and free of stains

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 3. Laminates, countertops, and other solid surfaces are:▪ Intact▪Undamaged▪ Clean and free of stains

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 4. Furnishings are clean and in good condition; free of rips, tears or other physical damage? (e.g. mattresses, chairs, couches, tables, lamps, etc.)

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 5. Patient care and medications refrigerators are:▪ Labeled▪Clean▪ Logs are maintained & actions documented for failed readings

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 6. Patient foods are dated, labelled and within expiration ranges?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 7. Stored supplies are elevated off the floor with solid surface bottom shelving?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 8. Corrugated cardboard is minimized in patient care areas and/or prohibited in sterile storage areas according to policy?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 9. Cabinets located under sinks are not used to store clean supplies or equipment?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 10. Clean equipment and supplies, including linen, are segregated from dirty and are stored according to policy?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 11. Clean linen is stored inside a dedicated room or is covered?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 12. Sharps containers are maintained less than 2/3 full?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 13. Needles, sharps, and syringes are secured when unattended?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 14. Required hand hygiene practices are followed?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 15. Medications and supplies are maintained within their respective expiration ranges.

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 16. Ice machines and coffee spouts are free of scale build-up?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 17. Patient nutrition stations are clean (ie. Microwave, refrigerator, freezer, countertops, etc)?

What is the likelihood to harm a patient / staff / Visitor?
Is the problem…

IC 18. Do you have any additional comments? If so, please add them here.

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Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.