Inspection

STANDARD PRECAUTIONS
Hand Hygiene

High visibility signs on educational literature on hand hygiene

Availability of hand washing area (with soap & water) and/or touch-free/ personal hand sanitizers anad hand dryers/disposable hand towels in all areas of the ER:

Triage

Resuscitation Bay

OB-ER

Isolation Room

Decontamination room

Minor operating room

Fast lane: Dengue & ORT

Internal Medicine

Pediatrics

Surgery

Orthopedics

ENT and Ophthalmology

Hand hygiene performed by ER staff as indicated*

Use of PPE

Proper sequencing of DONNING PPE upon room entry for Level 3 as follows: surgical gloves - N95 mask - googles/face shield - cap - disposable gown/impermeable coveralls

Level 2 : N95 mask — goggles/face shield

Proper sequencing of DOFFING for Level 3 as follows: disposable gown/impermeable coveralls - cap - googles/face shield - N95 mask - surgical gloves

Level 2: goggles/face shield — N95 Mask

During Doffing, always sanitize gloves bet. each step and sanitize/wash hands at the end

Remove and replace any PPEs with breaks/leaks

Remove all used PPEs as soon as duty ends properly discarding at the designated area before exiting

Used PPEs are placed in appropriate waste disposal area and properly sanitized

Use of Needle sticks and Sharp Objects

Proper orientation of health workers on the use and disposal of sharps including reporting and monitoring of needle pricks

Practice aseptic techniques during usage of needles (with IV insertion or blood extractions)

Never recap used needles but discard in proper sharps disposal

TRANSMISSION-BASED PRECAUTIONS

Appropriate patient placement in a single patient space, observing at least 1 meter distancing of ER beds

Limit to 1 watcher per patient

At least 1 meter of physical distancing for ambulatory ER consults

Patients and watchers wear masks

Proper cough etiquette is observed at all times

Limit patient transport and movement inside the ER

Equipment commonly used for multiple patients is cleaned and disinfected every after patient use

Avoid ambubagging, instead directly attached patient to mechanical ventilation

Use aerosol boxes and nebulization chambers

ENVIRONMENTAL CONTROLS

Clean and disinfect all surfaces (tables, chairs, floors and other high contact areas) every 4 hours

Waste is covered and segregated

Availability of PPE disposal container with cover

Has designated person to regularly collect and dispose wastes and used PPEs

Disposal of sharps to properly designed sharps container

Proper usage of ER work areas; eating of staff should be done at pantry area or other designated area

Use laminar air flow systems and if feasible install central or point-of-use HEPA filters for supply (incoming) air

Ventilate the room to maintain >12 ACH have means to monitor

Have means to monitor airflow patterns

Ambulance Transport

Staff wears Level 3 Protection PPEs

Proper dons and doffs PPEs

Proper waste segregation and disposal of PPEs

Cleans and disinfects the ambulance, equipment and staff every transport of patient

moments of hand hygiene include:

before touching the patient

before aseptic procedure

after body fluid exposure risk

after touching the patient

after touching the patient’s surroundings

after doffing of PPEs

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.