ISPT Emergency Room Checklist

• Conducted on

  Date

• Prepared by

• Location
  Address

STANDARD PRECAUTIONS

Hand Hygiene

• High visibility signs on educational literature on hand hygiene

  Yes

  No

  N/A

• 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

  Yes

  No

  N/A

• Resuscitation Bay

  Yes

  No

  N/A

• OB-ER

  Yes

  No

  N/A

• Isolation Room

  Yes

  No

  N/A

• Decontamination room

  Yes

  No

  N/A

• Minor operating room

  Yes

  No

  N/A

• Fast lane: Dengue & ORT

  Yes

  No

  N/A

• Internal Medicine

  Yes

  No

  N/A

• Pediatrics

  Yes

  No

  N/A

• Surgery

  Yes

  No

  N/A

• Orthopedics

  Yes

  No

  N/A

• ENT and Ophthalmology

  Yes

  No

  N/A

• Hand hygiene performed by ER staff as indicated*

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Level 2 : N95 mask — goggles/face shield

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Level 2: goggles/face shield — N95 Mask

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Remove and replace any PPEs with breaks/leaks

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Never recap used needles but discard in proper sharps disposal

  Yes

  No

  N/A

TRANSMISSION-BASED PRECAUTIONS

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

  Yes

  No

  N/A

• Limit to 1 watcher per patient

  Yes

  No

  N/A

• At least 1 meter of physical distancing for ambulatory ER consults

  Yes

  No

  N/A

• Patients and watchers wear masks

  Yes

  No

  N/A

• Proper cough etiquette is observed at all times

  Yes

  No

  N/A

• Limit patient transport and movement inside the ER

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Avoid ambubagging, instead directly attached patient to mechanical ventilation

  Yes

  No

  N/A

• Use aerosol boxes and nebulization chambers

  Yes

  No

  N/A

ENVIRONMENTAL CONTROLS

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

  Yes

  No

  N/A

• Waste is covered and segregated

  Yes

  No

  N/A

• Availability of PPE disposal container with cover

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Disposal of sharps to properly designed sharps container

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Have means to monitor airflow patterns

  Yes

  No

  N/A

Ambulance Transport

• Staff wears Level 3 Protection PPEs

  Yes

  No

  N/A

• Proper dons and doffs PPEs

  Yes

  No

  N/A

• Proper waste segregation and disposal of PPEs

  Yes

  No

  N/A

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

  Yes

  No

  N/A

moments of hand hygiene include:

• before touching the patient

  Yes

  No

  N/A

• before aseptic procedure

  Yes

  No

  N/A

• after body fluid exposure risk

  Yes

  No

  N/A

• after touching the patient

  Yes

  No

  N/A

• after touching the patient’s surroundings

  Yes

  No

  N/A

• after doffing of PPEs

  Yes

  No

  N/A