Audit

SAFETY

Are compressed gas cylinders strapped to the wall or otherwise secured in a non-tip base?

Check "E" cylinders oxygen supply.

Temperature logs signed off?

Are electrical panels kept clear within 3 feet in front of breaker panels?

Add media

Fire extinguisher inspection x 5 (documented on tags)

Are sharps containers disposed of when 3/4 full?

Eye wash station expiration date checked and verified to be in date?

Are the hallways free and clear of stored items or obstructions?

Is the patient nutrition refrigerator clean and defrosted?

Is the patient microwave clean and in good working order?

Are there space heaters present?

INFECTION CONTROL

Every room, closet, and enclosure is inspected.

Every drain is flushed with running water.

Clean linen stored off ground.

Clean linen properly store in clean utility room and covered and unwrapped from plastic.

Clean linen stored separate from dirty linen.

Clean "clean linen rack" monthly.

Soiled linen stored in proper linen bags in soiled utility room.

Any soiled bags leaking fluid(s).

High cleaning done. This includes dusting of air conditioning ventilation openings, top of refrigerators, and tall equipment.

Ceilings clear of staining.

Hand washing posters posted.

Report to local health department.

I'VE fluids stored properly and "in date".

Are there supplies stored under sinks.

Other issues identified.

Weekly cleaning log complete and placed in facility binder.

PHARMACY

Control medications properly stored and log sheets signed and verified by pharmacist.

Code cart medications checked for expiration date status and minimum quantity verified.

All medications checked for expiration date.

Medication refrigerator log checked and verified contents kept between 2-8 degrees Celsius daily.

No food stored in medication refrigerator.

Open multi dose medications correctly marked, dated, and properly stored.

Only authorized medications and supplies are present.

Medications are secured to include suture cart locked and not accessible to public.

Poison control telephone number clearly posted.

NO concentrated electrolytes are available in unit.

Topical medications are kept separate from PO and I'VE medications.

Flammable items stored properly.

LABORATORY

Controls and supplies are not expired.

Temperatures documented on LabDaq computer twice daily.

Levy Jennings controls for CBC reviewed.

Liquid controls for Piccolo completed.

NO food or drink in lab area.

No food or drink in lab refrigerator.

Wave testing log in order.

Send out computer logs reviewed.

OTHER

Chart reviews completed.

HVAC issues.

Water supply issues

Security related issues.

Safety related issues.

Sewer related issues.

Life safety issues.

Trash/waste/biohazard disposal issues.

Other related issues.

QUARTERLY (MARCH, JUNE, SEPTEMBER, DECEMBER)

Fire drill both shifts.

Clinical alarms checked and documented.

Hand washing data compiled for Infection Control meeting.

Needle stick log given to Safety Committee for meeting.

Medical gas system panels checked and operating.

Area alarms functioning.

Automatic pressure switches functioning.

Shut off valves operational.

Flexible connectors and valves functioning.

ANNUALLY. (REPORT IN JUNE)

Local fire department approval of plan.

Inspection of sprinkler system.

Inspection of fire extinguishers.

Inspection of back flow valve.

Inspection of riser room.

Policy and procedure review.

Medical gas inspections.

Service generator.

Disaster exercise.

Fit testing for all staff completed and in HR file at corporate.

ADDITIONAL NOTES OR COMMENTS

Dan Baas, RN CEN Nurse Manager
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.