General safety

Staff knowledgeable about Bee Ready Survey Guide

Staff knowledgeable about NOSG's

United staff observed Washing In/Out

Staff observed not blocking fire extinguishers

MD, nursing, ancillary staff maintains confidentiality of patient information

ES staff knowledgeable about chemical safety

ES knowledgeable about their role in infection control

National Patient Safety Goals

Can you list the 2 patient identifiers used at SH

Can you explain how correct patient gets blood

Within what timeframe are critical test results communicated

Can you explain how medications in syringes/basins/cups are labeled

Can you explain how anticoagulant administration is kept safe

Can you explain when & how med reconciliation is completed

Can you explain how to keep patients fire from infection prior to giving care

Can you explain SH guidelines for preventing resistive organism infections

Can you e plain SH guidelines for preventing central line infections

Can you explain SH guidelines on preventing post operative surgical infections

Can you explain SH guidelines for preventing UTI's from catheters

Can you explain how the correct surgery on the correct patient is confirmed

Can you explain how the correct place on the patients body is marked for surgery

Can you explain how surgery is confirmed to prevent mistakes prior to the surgery

Life Safety

Can you explain your role if a disaster causes an influx of patients

Can you explain how to report a safety related issue

Can you explain your role in a fire event

Can you tell me where the fire extinguisher is

Can you explAin PASSAGE fire extinguishing technique

Can you explain the SAVE acronym

Can you explain to me where the fire alarm pull stations are

Can you explain your role when a disaster is paged

Can you explain how/where to find the SDS information

Can you explain the policy on coming to work sick

Can you explain how to take care of malfunctioning equipment

Can you tell me who can shut off O2 valves in an emergency

Additional Comments

Additional Comments

Surveyor's Signature
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.