Title Page

  • Conducted on

  • Prepared by

  • Location

OB Delivery Room Checklist

1.Triage/Environment

  • Designated staff assigned for triaging patients for consultation and emergency procedures

  • Specific area provided for triaging

  • Specific area for donning and doffing provided

  • Lavatory for handwashing accessible

  • Area clean and well maintained

2.Supplies and Waste Disposal

  • PPE and supplies are available 24/7

  • Stock cards maintained and tallied for every receipt and consumption

  • Disinfecting supplies, gloves,

  • trashbag available

  • Proper disposal of waste

  • Disinfection thoroughly done

  • using proper disinfecting solution

  • Transport of waste using designated

  • trolleys

Operating Room CHECKLIST

A. Supplies

  • Supplies are made avaiable 24/7 like :

  • PPE

  • Disinfecting supplies, gloves, trash bag

  • OR supplies needed for the procedure

  • Circulating forms/pen

  • Emergency cart

  • Irrigating solutions, cling wrap

B. Ante Room/donning/Doffing/Shower Area

  • 1.Specific area provided for donning, doffing and shower room provided

C. Environment/Waste

  • Receiving area and holding area clean and well maintained

  • Sterility inside or maintained and monitored at all times

  • Specific stretcher for covid patient provided

  • Cleaning materials dedicated for OR used made available

  • Plastic cover sheet for each covid patient provided

  • Disinfection thoroughly done using disinfectant solution

  • Instruments and packs wash and labelled with COVID before sending to CSR for autoclaving/sterilization

  • Unused items on the trolley are considered contaminated and must be properly disposed/discarded

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.