Standard Precautions

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. Hand Hygiene

• 1.1 Staff are aware of the 5 Moments of Hand Hygiene policy

  Yes

  No

  N/A

• 1.2 Staff are aware hands are to be washed with soap and water if visibly soiled

  Yes

  No

  N/A

• 1.3 Staff adhere to the jewellery/nail polish/artificial nails policy

  Yes

  No

  N/A

2. Use of PPE

• 2.1 Staff are aware of the Standard Precautions and Transmission-based Precautions Policies and where they are located

  Yes

  No

  N/A

• 2.2 Aprons/gowns are worn for single procedures or episodes of patient care in line with policies

  Yes

  No

  N/A

• 2.3 Gloves are used in line with standard precautions

  Yes

  No

  N/A

• 2.4 Gloves are used as single use items

  Yes

  No

  N/A

• 2.5 Staff are aware of the location of face masks/shields and safety goggles

  Yes

  No

  N/A

3. Safe Use and Disposal of Sharps

• 3.1 Staff are aware of the Safe Handling and Disposal of Sharps Guideline and it's location

  Yes

  No

  N/A

• 3.2 Staff are aware of the Management of Health Care Workers Potentially Exposed to HIV, Hepatitis B and Hepatitis C Guideline and where to find it

  Yes

  No

  N/A

• 3.3 Sharps are disposed of at point of use

  Yes

  No

  N/A

• 3.4 Needles are not recapped

  Yes

  No

  N/A

4. Routine Environmental Cleaning

• 4.1 Staff are aware of the procedure for Management of Blood and Body Substance Spills and it's location

  Yes

  No

  N/A

• 4.2 Staff can indicate the location of a spills kit

  Yes

  No

  N/A

5. Reprocessing of Reusable Medical Equipment

• 5.1 Staff are aware of the policy for Reprocessing Reusable Medical Equipment and it's location

  Yes

  No

  N/A

• 5.2 Staff are aware of the Single Use Policy and it's location

  Yes

  No

  N/A

• 5.3 Single use items are not reprocessed

  Yes

  No

  N/A

• 5.4 Instruments are cleaned as soon as possible after use

  Yes

  No

  N/A

• 5.5 When equipment dishwasher is in use, care is taken with stacking equipment

  Yes

  No

  N/A

6. Respiratory Hygiene and Cough Ettiquette

• 6.1 Staff are aware of respiratory hygiene and cough ettiquette practices

  Yes

  No

  N/A

• 6.2 Staff are seen practicing respiratory hygiene and cough ettiquette

  Yes

  No

  N/A

7. Aseptic Technique

• 7.1 Staff are aware of the Aseptic Technique guideline and it's location

  Yes

  No

  N/A

• 7.2 Staff can articulate an understanding of the framework of Aseptic Technique including describing key parts and key sites

  Yes

  No

  N/A

• 7.3 A risk management approach is used to identify which type of Aseptic Technique is used

  Yes

  No

  N/A

• 7.4 Type of Aseptic Technique used is appropriate to the procedure being undertaken

  Yes

  No

  N/A

• 7.5 Staff have recently received education and achieved compliance in Aseptic Technique

  Yes

  No

  N/A

8. Waste Management

• 8.1 Staff segregate waste into correct receptacles

  Yes

  No

  N/A

• 8.2 Appropriate PPE is worn when dealing with waste

  Yes

  No

  N/A

9. Appropriate Handling of Linen

• 9.1 Staff are aware of the Handling of Soiled Linen Policy and it's linen

  Yes

  No

  N/A

• 9.2 Clean linen is only handled with clean hands

  Yes

  No

  N/A

• 9.3 Soiled linen is placed directly into a soiled linen bag

  Yes

  No

  N/A

• 9.4 Appropriate PPE is used when handling moist linen

  Yes

  No

  N/A