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

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.