Title Page

  • Document No.

  • Department / Audit Title

  • Hospital Facility

  • Conducted on

  • Prepared by

  • Location
  • Name of Nursing Unit Manager

0. Instructions

  • 1. Answer "Yes" or "No" 2. Add a photo by clicking on the camera icon 3. Add a comment or note by clicking on the "note" icon 4. Complete the inspection by providing your full name and a digital signature 5. Mark as complete, save and close 6. Enter any non-conformances into Riskman using the “Report It!” App, located on the iPad

1.0. GENERAL HOUSEKEEPING IN WARDS

  • 1.1. Are floors clear of debris and unwanted materials?

  • 1.2. Are corridors/walkways and passages free of obstruction [eg wheelchairs, chairs, equipment, walking aids, beds and trolleys etc]?. <br>UPLOAD A PHOTO <br>

  • 1.3. In the storerooms, are materials stored securely and limited in height to prevent collapse and over reaching?<br>UPLOAD A PHOTO

  • 1.4. Bins and sharps containers emptied regularly (no overflow). How often are they emptied?

  • 1.5. Are floor surfaces dry and free of slip hazards?

2.0. CHEMICAL SAFETY

  • 2.1. Are all hazardous materials, chemicals and drugs stored appropriately and labelled properly?<br>UPLOAD A PHOTO

  • Add media

  • 2.2. Are Safety Data Sheets readily available and accessible (in hard copy or electronically)? <br>Where are they available?

  • 2.3. Ask two staff members [and list their names] if they know where and how to access the Safety Data Sheets?

  • 2.4. Is a spill kit available and accessible? Where is it stored?

  • 2.5. Where required, is appropriate personal protective equipment and clothing available and are staff wearing it?

3.0. EMERGENCY SYSTEM

  • 3.1. Are emergency exits signs posted ?

  • 3.2. Are staff aware of location of the emergency assembly points? Where are they?

  • 3.3. Are emergency exit signs in proper working order and lit ?

  • 3.4. Are emergency exit maps posted and clearly marked ?

  • 3.5. Are emergency exits free from obstructions?<br>UPLOAD A PHOTO of the area leading up to the exit sign. <br>

  • Add media

  • 3.6. Do self-closing devices on stairway doors work properly? Please test

  • 3.7. Are services kept clear of obstruction i.e. gas, electricity, water ?

  • 3.8. Are emergency numbers displayed? Where are they displayed?

4.0. FIRE PREVENTION

  • 4.1. Are fire extinguishers in place, clearly marked and signs clearly visible?

  • 4.2. Extinguishers free of obstruction ?

  • 4.3. Is there any combustible material [paper / cardboard etc] stored near electricity or heat source?

  • 4.4. Has the extinguisher been tested and tagged? What is the date of the last test?

5.0. GENERAL LIGHTING

  • 5.1. Good natural lighting ?

  • 5.2. Light fittings clean and in good working order ?

6.0 ELECTRICAL SAFETY

  • 6.1. Is electronic medical equipment tested and tagged?<br>Provide an example of a piece of equipment and a test date. <br>

  • 6.2. Are there any broken plugs, sockets or switches?

  • 6.3. Are there any power leads crossing walkways?

  • 6.4. Are there any frayed or damaged leads?

7.0. OFFICE HAZARDS

  • 7.1. Are office chairs in good condition i.e. casters, back rest and arm rest ?

  • 7.2. Desks in good condition i.e. sufficient leg room under desk, no nails protruding and wood not splintered ?

  • 7.3. Is the ventilation in office sufficient ?

  • 7.4. Are there any electrical cords obstructing workers under desks?

8.0. MEDICAL GASES

  • 8.1. Are medical gas shutoff valves labelled clearly ?

  • 8.2. Are gas shutoff panels clearly accessible ?

  • 8.3. Are all oxygen tanks secured properly, ie chained or in bed holders?

9.0. ENVIRONMENT – WARDS/ROOMS

  • 9.1. Are walls and air vents free of dust ?

  • 9.2. Is there any visible damage to vent ducts? Are the vent ducts securely clipped in place? Do a visual inspection in a random area

  • 9.3. Are privacy curtains clean and unsoiled ?

  • 9.5. Are ventilation, temperature/humidity levels suitable for patient care and staff ?

10.0. General - Wards/Rooms

  • 10.1. Do staff know who the fire warden is for their area?<br>Who is the fire warden?<br>

  • 10.2. Do staff know who they report workplace injuries to?<br>Who do they report to?<br>

  • 10.3. Do staff know who their WHS representative is on the WHS Committee?<br>Who is it? <br>

  • 10.4. Do staff discuss safety at their team meetings?<br>When was the last minuted team meeting? UPLOAD A PHOTO of the minutes where safety was discussed <br>

  • Add media

  • 10.5. Is the WHS Policy, Injury Management Flowchart, Injury Management Program Summary, current WHS Minutes and fire warden information current and clearly displayed on the noticeboard?<br>UPLOAD PHOTO <br>

  • Add media

11.0 ADDITIONAL COMMENTS OR CONCERNS

  • Have all non-conformances been entered into Riskman?

  • Name of person conducting inspection

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