Audit

SAFETY MANAGEMENT

Housekeeping closets are locked (EC.02.01.01 EP8)

Soiled utility rooms are locked (EC.02.01.01 EP8)

Clean utility rooms are locked (EC.02.01.01 EP8)

Oxygen storage rooms are locked (EC.02.01.01 EP8)

Medication rooms are locked (EC.02.01.01 EP8)

Utility closets are locked (EC.02.01.01 EP8)

Handrails are firmly attached to the walls (EC.02.01.01 EP3)

SECURITY MANAGEMENT

All staff members are wearing hospital identification badges (EC.02.01.01 EP7)

Your department has flashlights that work properly and are stored in an easily accessible location. (EC.02.02.09 EP2)

Clean sharps are secured and locked in cabinets, carts, or locked containers (EC.02.01.01 EP3)

Doors that should be locked are locked to control access into your department from patients and visitors (EC.02.01.01 EP3)

Childproof protective outlet covers are located in outlets in lobbies, hallways, and public gathering points

All medications are secured (MM.03.01.01 EP3)

Medical records cannot be seen from the "public's" point of view at the workstations/nurse's station

Signage in your department is in good condition and reflects the current operational practices for your unit (LD.03.04.01 EP3)

Staff's belongings and personal items are not easily accessible by patients and visitors (EC.02.01.01 EP3)

HAZARDOUS CHEMICALS AND WASTE MANAGEMENT

Hazardous chemicals in your department are stored appropriately (EC.02.02.01 EP5)

Medical waste containers are not full and labeled with the date installed and expired (NOT MORE THAN 90 DAYS) (EC.02.02.01 EP12)

Sharps containers are not full in your unit. If they are please change these appropriately (IC.02.01.01 EP1)

INFECTION CONTROL

Staff's food and beverages are not present in patient care areas (LD.04.01.01 EP2)

Personal Protective Equipment (PPE) is adequately stocked and readily available; in good condition; and appropriate for your department (IC.01.02.01 EP3)

Linen carts are covered with impervious covering (IC.01.02.01 EP4)

Single soiled linen bags are not overfilled (EC.02.01.01 EP3)

Trash bags are not overfilled (EC.02.01.01 EP3)

No items are stored under sinks (LD.04.01.01 EP2)

Storage is at least 6" from the floor and no boxes are stored on the floor (IC.01.02.01 EP3)

Areas are clean, sanitary, and free from reoccurring offensive odors. These include lighting, vents, surfaces, walls, ceilings, and equipment (EC.02.06.01 EP20)

Paper towels are placed in the dispenser not placed on the countertops (NPSG.07.01.01 EP1)

Alcohol based hand rubs are not empty and dispensing properly (IC.01.02.01 EP3)

There are no rips or tears on vinyl covered patient equipment or chairs. (Stretchers, treatment table coverings, ect) (EC.02.06.01 EP26)

LIFE (FIRE) SAFETY MANAGEMENT

Hallways are free from all obstructions. This does NOT include crash carts, isolation carts, and equipment in use (this means accessed at least every 30 minutes or often) (LS.02.01.20 EP13)

Stored items are more than 18" from the bottom of the ceiling in any room (LS.02.01.35 EP6)

Sprinklers and smoke detectors look free from dust (LS.02.01.35 EP5)

Fire extinguishers and pull stations are not blocked at all times (LS.02.01.35 EP8)

Fire extinguishers have been inspected this month (Lock at the backside of the tag) (EC.02.03.05 EP15)

Emergency Exit signs are clearly visible and working properly (evenly illuminated) (LS.02.01.20 EP13)

Fire doors are not blocked from shutting and latching properly (LS.02.01.30 EP11)

Doors are not wedged open (LS.03.01.20 EP8)

Flammable decorations like natural Christmas trees are not present in the hospital at any time (LS.02.01.70 EP1)

UTILITY SYSTEMS MANAGEMENT

Sinks, showers, toilets, and water lines are in good repair (not leaking and working appropriately) (EC.02.06.01 EP1)

Extension cords are not used in your department (EC.02.03.01 EP1)

Electrical outlets are not damaged or loose and have covers. This also includes switches, and network connections (EC.02.03.01 EP1)

Electrical panels are labeled as such and locked (locked in public areas) (EC.02.05.01 EP8)

Medical gas shut offs are properly labeled and clear of obstructions (EC.02.05.9 EP3)

MISCELLANEOUS

Are there any slip and fall hazards in your department? (EC.02.01.01 EP3)

Any other concerns for your unit or area of inspection?

Please add and additional photos during this audit that are of a concern but do not fit into any of the above categories.
END OF SURVEY

Please complete this survey once a month. When complete, sign the document electronically and email it to reportit@mcmcbr.com

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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.