North Fulton Hospital EOC Rounds - 2014

• Facility

  Select North Fulton Hospital ASC Pain and Spine Center

  • North Fulton Hospital
  • ASC
  • Pain and Spine Center

• Unit

• Manager

• Unit Representative on tour

• Conducted on

  Date

• Prepared by

A. PREVIOUS AUDITS

• Has the last audit been reviewed?

  Yes

  No

  N/A

• Have all outstanding concerns been addressed?

  Yes

  No

  N/A
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• Identify outstanding concerns.

B. TOP REPEAT ITEMS

• Hallways clear of clutter.

  Yes

  No

  N/A

• Exit doors unobstructed.

  Yes

  No

  N/A

• No propped doors.

  Yes

  No

  N/A

• Storage (boxes etc.) are stored no less than 18" from sprinkler head.

  Yes

  No

  N/A

• Storages (boxes etc.) are 6" above floor.

  Yes

  No

  N/A

• No cracked, stained, or missing ceiling tiles.

  Yes

  No

  N/A

• No codes written on access control doors.

  Yes

  No

  N/A

• Outlets covered and in good condition

  Yes

  No

  N/A

• All junction boxes are covered.

  Yes

  No

  N/A

• No damaged building materials (e.g. walls, floors, ceilings, furniture, furnishings)

  Yes

  No

  N/A

C. STAFF AWARENESS

• Staff can identify Emergency Response<br>

  Yes

  No

  N/A

• Staff are wearing ID cards.

  Yes

  No

  N/A

• Employees know how to access SDSs, Chemical Inventory List available.

  Yes

  No

  N/A

• Personal items kept secured in work areas. (Handbags, Wallets)

  Yes

  No

  N/A

• Staff Code knows Code Red. What is RACE

  Yes

  No

  N/A

• Employees know the process for reporting a security incident, chemical spill, Code Red. (RACE)<br>

  Yes

  No

  N/A

• Staff knows who can shut off medical gases in an emergency.

  Yes

  No

  N/A

• Gas valves labeled and unobstructed

  Yes

  No

  N/A

• Staff demonstrates knowledge of Code Green Disaster response.

  Yes

  No

  N/A

• Personal Protective Equipment (PPE) available and worn when necessary.

  Yes

  No

  N/A

D. EOC

• Electrical closet/panels, mechanical closets, housekeeping closets are locked.

  Yes

  No

  N/A

• Fire extinguishers are clearly marked (signage). Checked monthly<br>

  Yes

  No

  N/A

• Fire extinguishers unobstructed. (3' clearance)

  Yes

  No

  N/A

• Exits illuminated; clearly and correctly marked.

  Yes

  No

  N/A

• Pull stations unobstructed (3' clear) and intact.

  Yes

  No

  N/A

• Smoke/Fire Doors close freely.

  Yes

  No

  N/A

• No smoking policy enforced (no visible signs of non-compliance).

  Yes

  No

  N/A

• Fire Tower Exits unlocked from floor (unless approved variance - special conditions).

  Yes

  No

  N/A

• Proper stair identification signage at landings.

  Yes

  No

  N/A

• Fire evacuation diagram signage posted at elevator call stations/landings.

  Yes

  No

  N/A

• Medical gas shut-off valves are labeled to indicate the area served.

  Yes

  No

  N/A

• Access control devices (card readers, combination locks) are in use and working properly.

  Yes

  No

  N/A

• Area is adequately lighted.

  Yes

  No

  N/A

• Sprinkler heads are free of foreign materials.

  Yes

  No

  N/A

• No unauthorized appliances (space heater, toaster).

  Yes

  No

  N/A

• Extension cords are not substituted for permanent wiring. (only approved surge power strips)

  Yes

  No

  N/A

• Entrances to areas storing hazardous chemicals are labeled properly.

  Yes

  No

  N/A

• Chemicals stored properly.

  Yes

  No

  N/A

• Gas cylinders properly secured.

  Yes

  No

  N/A

• Nurse call operates (random check)

  Yes

  No

  N/A

• Check eye wash station

  Yes

  No

  N/A

• Operating flashlight

  Yes

  No

  N/A

E. MEDICAL EQUIPMENT

• Equipment is clean and free from damage.

  Yes

  No

  N/A

• Equipment is free of frayed wires and/or faulty plugs.

  Yes

  No

  N/A

• Users of equipment is surveyed for recurrent problems.

  Yes

  No

  N/A

• Rechargeable equipment is plugged in.

  Yes

  No

  N/A

• Equipment is being routinely inspected as indicated by the Equipment management Plan.

  Yes

  No

  N/A

• Crash carts checked and plugged into emergency outlet

  Yes

  No

  N/A

F. MISCELLANOUS

• Alcohol based hand washing solution readily available (staff handwashing).

  Yes

  No

  N/A

• Clean linen cart covered, no items stored on top.

  Yes

  No

  N/A

• No food or drink in clinical work area.

  Yes

  No

  N/A

• Refrigerator Monitored by Primex Wireless

  Yes

  No

  N/A

• Clean and dirty linen are separated and never stored together.

  Yes

  No

  N/A

• Standards of cleanliness are maintained throughout.

  Yes

  No

  N/A

• HVAC vents free of dust.

  Yes

  No

  N/A

G. ADDITIONAL FINDINGS

• Is there any additional findings?

  Yes

  No

  N/A
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• Additionally findings 1:

• Is there any additional findings?

  Yes

  No

  N/A
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• Additionally findings 2:

• Is there any additional findings?

  Yes

  No

  N/A
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• Additionally findings 3:

SIGN OFF

• Department/Unit Representative

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• Auditor

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