Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Preparation areas
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Equipment and supplies stored safely
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Equipment is stored in a clean environment and easily accessible if required
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Preparation work surfaces are the correct size, clean and uncluttered
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Systems for cleaning reusable equipment are quite clear and known
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Procedure Area
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Are there appropriate hand cleaning facilities
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Are there appropriate waste disposal facilities
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Is the sharps container close to the procedure
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Have measures been taken to reduce any air movement during the procedure
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Equipment
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Is the equipment suitable for the procedure and in good condition
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Is the equipment clean and intact
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Aseptic precautions
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Is correct hand hygiene used as per hand hygiene 5 moments
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Is PPE used appropriate
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Are sharps and equipment disposed of safely after procedure
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Is hand hygiene applied on removal of gloves at end of procedure
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Aseptic technique
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Correct application of Standard or Surgical ANTT
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Key parts/key sites identified and protected
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Key parts/key sites are cleaned effectively prior to use
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Key parts/key sites are allowed to dry before use
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Non touch technique is evident and effective
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General aseptic fields are managed correctly
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Critical aseptic fields are managed correctly