Audit

Infection Prevention and Control Related

Approved alcohol hand sanitizer not expired

No patient care items are stored in the patient room

Curtains are clean and in good shape

No one time use equipment open in room

Only clean equipment in patient room

No used supplies

Gloves are available in patient room

Are all rooms with specific air pressurization requirements correct?

Staff knows location, operation and procedures for airborne isolation rooms

General Cleanliness/Housekeeping

Floors, walls, vents and light fixtures are clean

Cabinets are empty and clean

Shower curtains are clean

Toilets are clean (top, back, floors)

No hair/debris visible on drain

Linens are clean and free of tears

Bed handrails, tray, head and foot board are clean

Exterior windows are clean

Area/equipment is dust free, high and low level areas

Appropriate waste liners

Appropriate soap in patient rooms (2% chg w/out lotion)

There are no visible insects

Any foul oders

No taped signs or tape from previous patients

General Safety

Sharps containers are secured

Sharp containers are less than 3/4 full

Nothing stored above/on top of sharp containers

Are any tripping/slipping hazards present?

Nurse call cords are fully accessible and not tied up or touching floor

Utilities / Life Safety

Ceiling tiles are in place, free from stains, cracks, and holes

Floors and walls in good condition

Curtains are clean and have open mesh tip

Floors are clean with no visible markings

All light fixtures have working bulbs

No plumbing issues (dripping faucet)

Temperature is maintained and comfortable

Supply and return grilles are clean and free of dust

Miscellaneous

Appropriate type and amount of furniture and waste receptacles in patient room

Furniture is not stained or in poor condition

TV is working properly

Nurse call bed remote is clean and works properly

Patient lift equipment and slings are readily available

Patient equipment inspection updated and labeled with correct sticker

Additional Information

Auditor
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.