Title Page
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Date of audit
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Name of auditor
Questions
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Name of staff member being audited
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Is the staff member 'bare below the elbows'?
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Staff member can risk assess and identify the appropriate PPE to be worn:
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When there is a risk of contact with blood and/or body fluids (apron, gloves, eye/face protection if risk of splashing).
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When the resident has a known or suspected infection (apron, gloves).
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When handling used soiled, fouled or infected linen (apron, gloves).
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When cleaning a commode and/or commode pan (apron, gloves, eye/face protection if risk of splashing).
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Donning: Staff member can demonstrate or describe the correct procedure and order for putting on PPE after risk assessing the task.
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1. Washing hands or apply alcohol hand rub.
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2. Apply apron.
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3. Apply face mask if required.
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4. Apply eye/face protection if required.
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5. Apply gloves.
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Doffing: Staff member can demonstrate or describe the correct procedure and order for removing PPE.
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1. Remove gloves.
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2. Clean hands.
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3. Remove apron.
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4. Clean hands.
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5. Remove eye/face protection.
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6. Clean hands.
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7. Remove face mask.
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8. Wash hands.
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Staff uniform/work clothing is clean and fit for purpose.
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Footwear is well maintained, visibly clean, non-slip and supports and covers the entire foot to avoid contamination.
Sign off
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Signature of auditor