Title Page
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Conducted on
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Prepared by
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Location
1. Office set up - ergonomics
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An adjustable height and back rest, ergonomic chair with a five base used
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Feet’s and lower limbs are supported by floor or footrest
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Keyboard height allows shoulders to be relaxed
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There is adequate working space on desk
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Monitor approximately arm’s length from operator and eyes approximately level with top third of screen
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Monitor screen is free from glare
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Frequently used items are within close reach
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Postural change occurs every 25 - 30 minutes
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Repetitive twisting / bending of neck or back is avoided
2.Environment
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The temperature is adequate / comfortable
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Lighting and ventilation is adequate for the tasks required
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Good vision can be obtained at entry and exit points
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Walkways / traffic areas are clear of clutter
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Furniture and trolleys are arranged to minimise disruption to walkways
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Work surfaces are at an appropriate height
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Traffic flow in area does not cause risk of collision or injury
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Noise levels are not excessive within the department
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There is appropriate drainage to ensure water doesn’t pool on the floor
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Floors are even and have an appropriate slip resistance
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Floors are free from gaps / holes / cracks
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Stairways have adequate handrails, are clear of clutter and in good repair
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The workplace amenities used by the staff are adequate and in a clean condition
3. Electrical
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Electrical appliances, cords, and equipment have been tested and tagged. Please check all items and advise when NEXT EXPIRY date is out of all of the items
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Detail next expiry date
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Electrical cords, extensions, plugs and switches are safely arranged and in good repair I.e. plastic covering intact
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Electrical cords are secured to prevent trip injuries
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Piggy back plugs (double adaptors) are NOT used in the department
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Electrical equipment is not exposed to water
4. Personal Protective Equipment
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PPE and disposable gloves, glasses, aprons and ear protection are available for use and in good condition
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Staff are wearing the required PPE
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Detail ONE item of PPE worn :
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Staff are wearing appropriate footwear I.e. non - slip rubber soled shoes
5. Equipment / Machinery
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Safety steps or step ladders are available to enable access to all storage areas
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Ward trolleys, beds, commode chairs and other wheeled equipment neatly arranged wheels and brakes are adequate and in good repair, all chairs are in good repair - patients and visitor
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Any damaged equipment has been removed from service until repair / replacement
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All powered equipment and machinery is in good working order
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Out of service or danger tags are available to place on faulty / damaged equipment
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All machinery and equipment is maintained and serviced as per the manufacture’s or suppliers guidelines. Observe service records and detail when the last service date was out of all of the equipment / machinery
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Correct machinery / equipment is used for required tasks
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All self help poles (monkey bars) manufactured by MEDICRAFT have been removed from service and disposed of
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Drip / monitor stands are easy to propel and do not over balance I.e. must have a 5 point base
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Gazunda safety check including : emergency stop, charger, emergency backup bar & horn
6. Housekeeping
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Wet floor signs are available and used
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Equipment not in use is removed to storage or disposed of
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The environment is free of trip / slip hazards
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The floor is free from rubbish, debris and or spills
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Adequate bins are provided to dispose of rubbish
7. Emergency
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Fire extinguishers and a hose reel are in close proximity, clearly marked and have been tested within the last 6 months
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Detail when the fire extinguisher was last tested (will be displayed on the metal tag on the neck of the extinguisher)
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Emergency exit signs are lit and are clearly marked and visible
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Fire and smoke doors are clearly signed
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Exit doors open and close and are free from obstructions
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Emergency procedures (code red - fire, code orange - evacuation, code brown - ext emergency) are contained in the fire box at the emergency assembly points and are in date
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Emergency wall plans are in place clearly showing, exits and firefighting equipment
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Emergency procedure flip books are located next tto o every staff telephone
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Staff are aware of emergency procedures and how to raise the alarm - DIAL 55
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Ask FIVE staff members 1. 2. 3. 4. 5.
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Smoke / detectors are free from damage / obstruction
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All emergency alarms have been tested I.e. duress alarm
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First Aid kit is available and fully stocked
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Staff have received basic fire extinguisher training
8. Storage
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Items stored on shelves are not stored too high. I.e. items on top shelves should be one box high
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Are items stored appropriately I.e. Frequently used items and heavy items stored between knee and shoulder height
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Materials are stored securely to prevent falling
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Shelves are secured to the walls / floors to prevent falling
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Gas cylinders are stored upright and are within a racking system or non - abrasive chain
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Storage rooms are neat and tidy to allow a clear walking path and are free from rubbish
9. Chemicals
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Safety data sheet (SDS) book is stored with the chemicals in the chemical storage / cleaners room
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CheMical containers are labeled with the manufacture / suppliers label
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Spill kits are available to clean up chemical spills (in bulk chemical storage areas)
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Appropriate PPE is worn by staff working with chemicals
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All chemicals are stored to prevent unauthorised access and storage areas are locked I.e. cleaners room
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All items containing mercury have been removed from service and returned to WHS department for disposal
10. Manual handling
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Staff follow correct patient manual handling and materials manual tasks procedures
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Staff have received patient and materials manual handling training within the last year
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Staff are not required to undertake tasks lifting excessive weight
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Manual handling aids are available on the ward to reduce the need for manual handling I.e. slide sheets, gazundas
11. Workplace Health and Safety Information
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The below policies are displayed in the work area and signed by the hospital executive. * Work Health and Safety * Manual Handling. * Zero Tolerance - Aggression & Violence * Return to Work & Rehabilitation
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Current Workplace Health and Safety Subcommittee Minutes are displayed in work area
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Current monthly Safety reports are displayed in area
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Injury Hotline poster displayed in work area
12. Policy and Procedure
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Policy and Procedures are followed at all times and are up to date
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Safe Operating Procedures (SOPs) are in place for all tasks and are up to date
13. Agency / Casual / Contractor Staff
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All agency / casual / contractor staff have received the contractor orientation induction checklist and ward specific orientation handout
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All agency / casual staff have signed the ward attendance register
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All agency / casual staff are wearing appropriate ID badges
14. Security
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Identity badges are visible and worn at all times, including agency, doctors, students and contractors
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Designated areas are limited to authorised personnel at all times I.e. treatment rooms, storage areas etc
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Aggression in the department is recognised, managed and coordinated in effective manner
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The majority of the staff have had training in aggression management
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Aggression management plans are in place as required and for frequent flyers with PMx of aggression
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CCTV cameras are functioning and cover high risk areas and access points
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Security personnel are available at all designated times in the department
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Access / Entry to the department is controlled
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Duress alarms are easy to locate and access in high risk areas
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Staff carry pagers and respond to department duress calls
15. Waste management
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All waste is contained and disposed of in appropriate waste stream I.e. general, clinical confidential, cytotoxic
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Total Number of Corrective Actions
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Completed by
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Department Manager Name
