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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Nightlights are checked and working
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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
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All staff are wearing HI Vis clothing
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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Pallet jacks, trolleys and materials transporting equipment are in good repair
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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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Knives / scissors are stored in an appropriate location
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Equipment register is available and up to date in the department
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Staff are trained in the use of all equipment
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Staff are licensed as required I.e. forklift use - must sight license of a forklift operators
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The forklift / walker stacker have the daily restart checklists completed - must sight 1/12 records and verify
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All machinery and equipment is maintained and serviced, as per the manufactures or suppliers guidelines
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Detail last service date
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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Ward is generally clean I.e. free from dust
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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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 / heat detectors are free from damage / obstruction
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All emergency alarms have been tested I.e. duress alarm
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Emergency eye wash station and shower - test by operating the shower and the face wash
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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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Materials are stored securely to prevent falling and can be accessed by the forklift / pallet jack with ease I.e. not stored out of reach and or obstructing access to other materials
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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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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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Chemicals are stored appropriately I.e. bunded and stored in locked chemical room
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All chemicals are stored to prevent unauthorised access and storage areas are locked
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
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A laminated patient mobility guide and risk assessment tool is located in the bedside patient care folder and in prominent locations in the clinical work areas (verify in patient files)
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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No unauthorised staff can access the stores or back dock area.
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
