Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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DAILY ENVIRONMENTAL CHECK
PURPOSE: Due to recent incidents within Monash Health, where it has been discovered that smoke detectors have been tampered with or physically removed to enable smoking in bedrooms, this updated environmental check will provide a system to ensure that rooms are not cluttered with mess- which poses a trip hazard or fire risk, that dangerous items are removed from bedrooms such as lighters, plastic bags, razors , and that smoke alarms are not damaged or removed.
METHOD: to be done daily at double staff time, to be conducted by the last person on am board and first allocated pm board. ANY EVIDENCE OF TAMPERING WITH SMOKE ALARMS ARE TO BE REPORTED TO ANUM- BEIMS TO BE COMPLETED IMMEDIATELY. REPORT TO BE EMAILED TO jimmy.castro@monashhealth.org once audit complete. -
BED 1- CHECK THE BEDROOM AREA AND BATHROOM AREA- CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 2 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 3 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 4 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 5 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 6 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 7 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 8 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 9 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 10 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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IS THE REAR COURTYARD DOOR LOCKED?
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IS THE POOL ROOM LOCKED IF NOT IN USE?
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IS THE POOL ROOM SUPERVISED IF IN USE?
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HAS THE PATIENT FRIDGE TEMP BEEN CHECKED? REPORT TO PSA IF NOT.
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IS THE PATIENTS KITCHEN CLEAN? Notify PSA if cleaning required.
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HAS THE OT FRIDGE TEMP BEEN CHECKED? REPORT TO PSA IF NOT.
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BED 11 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 12 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
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SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 13 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 14 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 15 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 16 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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Has the Medication fridge temperature been recorded? If not, record on form attached to door.
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The medication room is to remain clean at all times. Please notify the Medication nurse to tidy the room if messy/dirty.
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BED 17 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 18 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 19 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 20 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 21 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 22 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 23 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 24 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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IS THE LAUNDRY DOOR CLOSED WHEN NOT IN USE?
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IS THE LAUNDRY CLEAN AND TIDY? IF NOT, NOTIFY PSA.
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IS THE REAR COURTYARD DOOR LOCKED?
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HAS THE STAFF ROOM FRIDGE TEMP BEEN RECORDED? REPORT TO PSA IF NOT DONE.
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BED 25 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 26 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 27 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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BED 28 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
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IS THE TREATMENT ROOM CLEAN AND TIDY? IF NOT, PROCEED TO CLEAN MESS.
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HAVE THE LINEN SKIPS BEEN CHANGED? If not, replace bags.
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AMA BED 29 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
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FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
-
AMA BED 30 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
-
FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
-
AMA BED 31 - CHECK THE BEDROOM AREA AND BATHROOM AREA-CHECK WALLS/DOORS FOR DAMAGE.
-
FLOOR SHOULD BE FREE OF PATIENT BELONGINGS, RUBBISH, TRIP HAZARDS. Check for and remove cigarettes, lighters, sharps and plastic bags.
- FLOOR CLEAR OF CLUTTER
- FLOOR CLUTTERED WITH MESS
-
SMOKE DETECTORS ARE TO BE FREE FROM OBSTRUCTION, MUST BE VISIBLY SECURED TO THE ROOF (DO NOT CLIMB TO CHECK). WATCH FOR WET PAPER, TOOTHPASTE OR ANYTHING COVERING THE DETECTOR
- SMOKE DETECTORS INSITU/ UNDAMAGED
- SMOKE DETECTOR DAMAGED/ REMOVED
-
HAVE ANY ISSUES BEEN FOUND DURING THE ENVIRONMENTAL CHECK?
- NO ISSUES FOUND
- ISSUES FOUND
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HAS A BEIMS BEEN COMPLETED TO RECTIFY ANY SMOKE DETECTOR DAMAGE?
- BEIMS SENT
- BEIMS NOT SENT
- N/A
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HAS THE CONTACT NURSE BEEN NOTIFIED TO ENGAGE THEIR PATIENT TO REMOVE TRIP HAZARDS IN BEDROOMS?
- CONTACT NURSE NOTIFIED AND ISSUES ADDRESSED
- CONTACT NURSE INFORMED/ PT REFUSED TO CLEAN
- CONTACT NURSE NOT INFORMED/ REFUSED TO ADDRESS
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Sign your name and designation.
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ONCE THIS IS COMPLETE, PLEASE PRESS:
1. EXPORT
2. SEND AS PDF
3. SEND TO EMAIL
4. SEND TO jimmy.castro@monashhealth.org FOR RECORDING.
