THAM EOC Rounding

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Safety & Security

• Is clean linen covered and separated from dirty linen?<br>

  Yes

  No

  N/A

• Are sink cabinets screwed shut?<br>

  Yes

  No

  N/A

• Is only hospital-approved hand lotion in use?<br> <br>

  Yes

  No

  N/A

• Are sinks clean and unobstructed? (supplies 6 inches from sink minimum)<br>

  Yes

  No

  N/A

• Is PPE available (i.e. cabinets/wall hangers stocked, especially isolation rooms)? <br>

  Yes

  No

  N/A

• Are clean patient items stored off the floor at least 8 inches?<br>

  Yes

  No

  N/A

• Are alcohol hand sanitizer, soap, (within date) and paper towels available?

  Yes

  No

  N/A

• Do all wire storage units have a solid bottom shelf (or liner) if in use for clean storage?

  Yes

  No

  N/A

• Are clean patient items stored in clean bins (i.e. not outside shipping cartons)?<br>

  Yes

  No

  N/A

• Are temperature logs on med/food refrigerators complete and within acceptable limits (or action noted)?<br>

  Yes

  No

  N/A

• Are sterile items within expiration dates and/or acceptable package integrity?

  Yes

  No

  N/A

• Are medication and food refrigerators clean?

  Yes

  No

  N/A

• Is patient food separated from staff food?<br>

  Yes

  No

  N/A

• Are no expired medications or food items present (including no open food cartons)?

  Yes

  No

  N/A

• Are pill crushers clean?

  Yes

  No

  N/A

• Are trash cans not overfilled?<br>

  Yes

  No

  N/A

• Are there no staff food or open drink containers in patient care areas?

  Yes

  No

  N/A

• Are bases of rolling equipment (IV poles, WOWs, carts) clean and dust free?<br>

  Yes

  No

  N/A

• Is cleaned equipment easily identified as ready for use (e.g. bagged)?

  Yes

  No

  N/A

• Are surfaces in clinical areas cleanable (vinyl chair covering, sealed surfaces, etc.)?<br>

  Yes

  No

  N/A

• Are no live potted plants in clinical areas (except for patient rooms)?

  Yes

  No

  N/A

• Are all staff (including physicians and contractors) wearing ID badges in plain view? <br>

  Yes

  No

  N/A

• Are storage and equipment rooms free of clutter and unsafe conditions?<br>

  Yes

  No

  N/A

• Are wet floors clearly marked with signage?

  Yes

  No

  N/A

• Are general areas clean and free of clutter?<br>

  Yes

  No

  N/A

• Are mechanical, electrical, janitorial, and communications (data) rooms locked?

  Yes

  No

  N/A

Hazardous Materials

• Are sharps containers less than 2/3 full?

  Yes

  No

  N/A

• Are items not being stored on top of sharps containers?

  Yes

  No

  N/A

• Are all hazardous areas identified with proper signage?

  Yes

  No

  N/A

• Are eyewash station irrigation bottles sealed and within date (if applicable)?<br>

  Yes

  No

  N/A

• Are plumbed eyewash stations flushed for 3 min weekly (minimum) and logged?

  Yes

  No

  N/A

• Are chemicals stored separately from food or other clean items?

  Yes

  No

  N/A

• Is there a hazardous spill kit available (for appropriate areas)?

  Yes

  No

  N/A

• Are secondary chemical containers labeled with product name/<br>hazard label/manufacturer/expiration date?

  Yes

  No

  N/A

• Are hazard spill and exposure signs posted (for appropriate areas)?

  Yes

  No

  N/A

• Are medical specimens labeled appropriately and transported in leak-proof<br>containers/bags?

  Yes

  No

  N/A

• Are appropriate containers in use for biohazard waste?

  Yes

  No

  N/A

• Are biohazard rooms secure?

  Yes

  No

  N/A

• Are red biohazard bags available in the biohazard rooms?

  Yes

  No

  N/A

Fire Safety

• Is area free from evidence of smoking/tobacco use?

  Yes

  No

  N/A

• Are Fire Pull stations unobstructed?

  Yes

  No

  N/A

• Are oxygen cut-off valves clearly marked and unobstructed?

  Yes

  No

  N/A

• Are electrical panels in the area closed and locked if not in a room?

  Yes

  No

  N/A

• Are compressed gases (i.e. O2 tanks maximum 12 per storage area) stored properly?

  Yes

  No

  N/A

• Are all exit doors and stairwells clear?

  Yes

  No

  N/A

• Are fire doors not propped or held open?

  Yes

  No

  N/A

• Are fire extinguishers present and in date?

  Yes

  No

  N/A

• Do all doors close and latch properly?<br>

  Yes

  No

  N/A

• Are items stored 18” below ceiling/sprinklers?

  Yes

  No

  N/A

• Are computers on wheels, beds, and equipment stored in alcoves or equipment rooms rather than hallways?

  Yes

  No

  N/A

Utilities/Facilities

• Are ceiling tiles clean, stain-free, and in good condition?

  Yes

  No

  N/A

• If patient is in Airborne Isolation, is negative air sufficient (>0.01”), alarm activated, and log up to date (confirm with Plant Ops)?

  Yes

  No

  N/A

• Are walls in good repair without holes or torn sheetrock?

  Yes

  No

  N/A

• Are lights in working order?

  Yes

  No

  N/A

• Is area free of leaks or signs of water damage?

  Yes

  No

  N/A

• Is area appropriately heated or cooled?

  Yes

  No

  N/A

• Is the hot and cold water system working well?

  Yes

  No

  N/A

• Is the flooring free from trip hazards such as loose tile or carpet?

  Yes

  No

  N/A

Medical Equipment

• Is all equipment (beds, wheelchairs, desk chairs, IV poles, etc.) in good repair?

  Yes

  No

  N/A

• Are all medical equipment tags current?

  Yes

  No

  N/A

• Has all electrical equipment been approved by Clinical Engineering (Biomed)?

  Yes

  No

  N/A

• Are there no 2-prong extension cords in use?

  Yes

  No

  N/A

• Is equipment free from any exposed wires?

  Yes

  No

  N/A

• Is critical medical equipment plugged into red outlets?<br>

  Yes

  No

  N/A

• Are warmers within temperature recommendations (Fluids <110 f Blankets <130 f)?<br>

  Yes

  No

  N/A

Medication Safety

• Are all drugs secured (in constant direct observation or locked)?

  Yes

  No

  N/A

• Are tackle boxes locked (and in a locked cabinet or room if in an unmanned area)?

  Yes

  No

  N/A

• Are all decentralized medication units locked with no keys in them?

  Yes

  No

  N/A

• Have all medications been checked for expired items?

  Yes

  No

  N/A

• Are opened medication vials dated and discarded after 28 days?

  Yes

  No

  N/A

• Are syringes labeled, dated, and secured?

  Yes

  No

  N/A

• Is medication Pyxis clean on the inside?

  Yes

  No

  N/A

Crash Carts

• Are crash cart logs complete and readily available with only current month in book?

  Yes

  No

  N/A

• Have defibrillator pads been checked for expiration?

  Yes

  No

  N/A

• Have dates on drawers been checked for expiration?

  Yes

  No

  N/A

• Are cart locks intact?

  Yes

  No

  N/A

HIPPA- Patient Information

• Is patient information secure and out of public view (i.e. charts closed, clipboards covered, shred bins secure, computer screens signed off when unattended)?

  Yes

  No

  N/A

• Are discharged patient belongings bagged and labeled with date, stored in soiled equipment room, and awaiting Security pick up less than 24 hours?

  Yes

  No

  N/A

• Are downtime computers not in routine daily use?

  Yes

  No

  N/A