Title Page

  • Conducted on

  • Location

Information

Disclaimer The assessors believe the information contained within this risk assessment report to be correct at the time of printing. The assessors do not accept responsibility for any consequences arising from the use of the information herein. The report is based on matters which were observed or came to the attention of the assessors during the day of the assessment and should not be relied upon as an exhaustive record of all possible risks or hazards that may exist or potential improvements that can be made.

Confidentiality Statement In order to maintain the integrity and credibility of the risk assessment processes and to protect the parties involved, it is understood that the assessors will not divulge to unauthorized persons any information obtained during this risk assessment unless legally obligated to do so.

REPORT

STANDARD

  • <br>Pressure monitor fixed beside the outer door with audio visual alarm when there is loss of negativity for selected time, better to be connected to the building management system (BMS)

  • Minimum pressure difference between the patient room and outer corridor is - 2.5 Pascale

  • There is sign for (isolation room) and frame for recommendations of airborne isolation and patient’s information

  • Hand washing sink in ante-room (approved specifications) with supplies for hand hygiene

  • Personal protective equipment drawer or trolley available

  • Anteroom door (if present ) has<br>auto closure device

  • Patient’s room door has auto<br>closure device

  • Patient room walls and ceilings are smooth one piece without cracks or decorative parts , all openings for services or connections are carefully sealed and painted with antimicrobial paint can withstand repeated cleaning disinfection

  • All angles between walls and ceiling are rounded (no acute angels)

  • Floor covered by smooth anti- microbial vinyl without connection cracks or any other cracks, elevated ends to the wall and smooth line with wall and this line painted with epoxy paint , angels with wall must be circular

  • Window could not be opened and completely sealed

  • Curtains (window/bedside) must be washable.

  • Wooden surfaces if present must be covered or painted to be non- permeable, easy to be cleaned and disinfected repeatedly

  • All doors open to the inside

  • Air diffusing vent over the tail of<br>the bed

  • Air exhaust vent over the head of the bed or in the wall beside the head about (60- 100) cm from the floor

  • All exhausted air from patient room and bathroom must be100 % exhausted (no recirculation) after being filtered through HEPA filter.

  • Exhaust air tubes must be away at least 3 meters from the intake lines of other departments.

  • 100% fresh air supplied.

  • Air conditioned air supplied through chiller concealed units(not allowing air circulation) specified for the patient room or using supply line from central AC with automatic closure dampers (in case of any system failure ).

  • Minimum air change per hour is 12 ACH

  • Air supply and air suction systems connected to emergency source of electricity in case of emergency

Documents for negative pressure rooms

  • Monitor readings recorded every day in a document (nursing staff) .

  • Documented Biomedical engineering check for the pressure and air change per hour every month

  • Documented change of HEPA filter according to manufacturer recommendations.

  • Documented yearly calibration for pressure monitor

  • IPC Practitioner

This section is approval of receiving a copy of the evaluation for the department that has been evaluated

  • Acknowledgment of receipt of the report

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.