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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Select date
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Work areas are neat and orderly<br>
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Is there a step stool/ ladder available for reaching overhead objects?
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Is eating and drinking prohibited in work areas?
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Supplies and stock not stored on floors or under sinks (small quantities of cleaning products only)?
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All lights are operating properly?
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Storage rooms are clean and orderly and shelving is secure?
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Temporary equipment in corridor is placed on one side of hall?
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Check Nurse call system including bath room alarms.
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No sharp edges on furniture or equipment?
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Computer, electrical and phone cords are secured and bundled when appropriate?
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Office and work stations are ergonomically correct. Chairs are adjustable and employees know how to make adjustments? Casters roll freely?
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Tile and carpet are in good condition (no missing pieces, holes, flaps or tears) Rugs available and in good condition when needed?
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Staff clothing and footwear are appropriate?
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Stretchers, beds, wheelchairs and carts are in good working order?
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Emergency pull cord present and working in the bath room, not more than 6 inches from floor? (Check at least one patient room).
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Proper personal Protective equipment (PPE) provided and being worn?
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Are universal and standard precautions followed?
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Is excess water removed from floors or shower/ therapy areas?
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Is area free of Slip, Trip, Fall hazards?
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Are wet areas identified, barricaded and only mopped 1/2 at a time?
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Are drawers and cabinet doors kept closed?
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Teamwork promoted and encouraged?
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Poll at least two employees to evaluate their knowledge of various employee safety and security programs (role during various codes).
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Observe employee using proper body mechanics for materials handling.
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Observe staff repositioning a patient in bed ( I.e., pulling patient up in bed).
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Observe staff transferring patient to different level (I.e., from chair to bed).
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Observe a lateral transfer (I.e., bed to stretcher or exam table).
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Are all employees wearing name badge/ identification?
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Are vendors and contractors wearing proper identification?
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Interior and exterior lighting is adequate?
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Are unauthorized people questioned?
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Department is secured after hours?
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Are restricted access rooms (medication, EVS, offices) secured as required?
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Employee valuables stored in a secure area?
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Hospital property properly secured?
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Access controlled to the public and/or unauthorized persons?
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Safe room available in ED?
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Is employee able to verbalize signs for identifying agitated individuals and techniques to de-escalate a situation?
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Controlled access areas are operating accordingly?
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Additional notes.
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