3 foot clearance maintained between fire panels, med gas shut offs, fire extinguishers, and pull stations

All drinks are covered and no staff food in patient care areas

All laryngoscope blades & handles are clean and in original packaging (blades are in a peel pack or sterile tray, handles in a zip lock bag clearly marked clean, airways are individually wrapped in original packaging and sealed)

All non-patient room doors are closed and devoid of door props (look for offices supply rooms, break rooms, and so on)

All personal health information secured (face sheets, unlocked computers, patient stickers all have PHI on them)

All staff members, physicians, contractors and vendors have appropriate name tag attached above his or her waist

Ceiling tiles are in good condition with no stains or visible damage

Ceiling vents are clean and free of visible dust, dirt, or discoloration

Clean linen is kept covered no pillows on top

All logs are appropriately up-to-date with no blanks.
• Code Carts: Daily check unless unit is closed. If unit is closed, this must be marked on the log
• Eyewash: Weekly for plumbed eyewash stations, check by expiration date for bottles
• Fridge and freezer logs: Daily

Doors close, latch, and are in good condition (look for dents, damage, or chipped paint)

Food in patient nutrition refrigerator labeled and dated with patient information and the kitchen space is clean

Furniture is in good condition with no stains, chips, or damaged fabric. Please check at least 5 pieces of furniture

Hallways, fire doors, and exits are clean and clear, all wheeled objects need to be moved out of the egress corridor. Only crash carts and/or isolation carts may be stored in corridors

O2 cylinders secured (i.e. in appropriate cage tanks and not stored on wheelies, leaning against walls, etc.) and there are no more than 12 cylinders stored in a smoke compartment.

Preventive maintenance (PM) stickers current. Please check at least 5 pieces of equipment

Supplies are within the expiration date, including lab specimen tubes.
NOTE: Open supplies (EKG leads, spiked IV bags, IV bags outside of the protective packaging) expire much quicker than supplies within the bag. Expiration must be dated and timed.

Sharps container has only sharps (no medication vials, band aids, PHI, other trash)
Please check at least 3 bins

All cleaning supplies (buckets, spray bottles, etc.) are appropriately labeled with type of cleaning agent

Testing strips (5 months) & QC solutions (3 months) for glucose monitors are dated

The unit is clear from shipping boxes and wooden pallets (boxes may be in dirty utility room, off the floor)

Unit/department is clean including drawers and cabinets. (Please look on top of high surfaces for dusting- think picture frames)

Walls are in good condition and devoid of dents or chipped paint

All suction tubing and single patient use supplies are in protective packaging
**Check supply/airway carts to ensure items are individually packaged as required

Ultrasound gel bottles dated with 30 day expiration date.
Multiuse medication bottles/vials. Once opened need a new expiration date 28 days after opening.

Saline and saline flushes, as well as IV supplies, are secured and not accessible to patients

Emergency pull cords in patient bathrooms are not looped around grab bars

EOC Buddy Hand Hygiene
• For nursing units and procedural areas only!
• Watch for staff performing hand hygiene (foam or soap & water) as they enter or exit patient rooms
• Document good and bad hand hygiene by staff type (i.e. RN – Yes, PCT – No, MD – Yes)
• Only count hand hygiene if you are 100% sure the staff member did or did not foam or wash their hands
• Be secretive; don’t tell staff you are watching hand hygiene compliance!

OTHER: Document any other items you have observed.

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.