Trinity EOC Rounds March

• Conducted on

  Date

• Prepared by

• Department/Unit

Caregiver Recognition

• Caregiver nomination forms available on the unit

  Pass

  Fail

  N/A

Environmental

• ★ Bottom open shelving racks have solid liner

  Pass

  Fail

  N/A

• Department generally clean & free of visible dust

  Pass

  Fail

  N/A

• ★ Linen properly stored (covered & not overflowing)

  Pass

  Fail

  N/A

• Slip & trips fall hazards mitigated

  Pass

  Fail

  N/A

Facilities

• ★ Pressure relationships are appropriate for: Sterile processing (clean & decon), Operating Rooms & procedural rooms, Soiled utilities, & Clean utilities.

  Pass

  Fail

  N/A

• ★ Construction site checks completed: 1. Barrier is present & intact 2. Air pressure relationship is correct. 3. ICRA in place 4. Sprinklers heads turned up if ceiling is removed

  Pass

  Fail

  N/A

• ★ Ceiling tiles present, clean, & in good condition

  Pass

  Fail

  N/A

• Walls & ceilings in good condition & free from penetrations, gaps between ducts and ceiling tile, and exposed tubes or wires.

  Pass

  Fail

  N/A

• Power strips appropriate

  Pass

  Fail

  N/A

• Breaker panels locked & not blocked

  Pass

  Fail

  N/A

• Doors functioning properly (closing & latching)

  Pass

  Fail

  N/A

• Walls and furniture in good repair without holes or rips

  Pass

  Fail

  N/A

Crash Cart

• ★ Daily checklist completed and accurate and only the current month's log is on the crash cart.

  Yes

  No

  N/A

Life Safety

• ★ Fire equipment (e.g., extinguishers, pull stations, fire hoses), Medical gases, & Electrical panels free from obstructions

  Pass

  Fail

  N/A

• ★ Sprinkler head clear of dust/debris

  Pass

  Fail

  N/A

• ★ Egress is clear & maintained.

  Pass

  Fail

  N/A

• ★ Fire doors are not blocked & latch appropriately.

  Pass

  Fail

  N/A

• Check stairwells that open to your area to assure no equipment is stored there

  Pass

  Fail

  N/A

• ★ Fire panel does not have a trouble signal

  Pass

  Fail

  N/A

Medical Equipment

• ★ Oxygen tanks secured & stored in proper bin with no more than 12 per smoke compartment

  Pass

  Fail

  N/A

• In rooms where oxygen is stored, is there an appropriate sign denoting "Medical Gases: No smoking or open flame"

  Pass

  Fail

  N/A

Infection Control

• ★ Used reusable surgical/procedural instruments removed from soiled utility rooms in departments performing bedside procedures (i.e. ED, ICU, etc.)

  Pass

  Fail

  N/A

• ★ Check soiled utility room for red biohazard bins containing soiled reusable surgical instruments, ensure they are doused in Preklenz. Remove bin from area.

  Pass

  Fail

  N/A

• Sharps containers less than ¾ full and located neat point of use

  Pass

  Fail

  N/A

Pharmacy Practices

• Open vials of medications / sterile solutions are dated & stored properly

  Pass

  Fail

  N/A

• ★ Medications secured, no unsecured sharps, or syringes

  Pass

  Fail

  N/A

• There are no expired medications/items/supplies

  Pass

  Fail

  N/A

Staff Responses

• ★ Staff know how to locate & identify who is authorized to turn off medical gas valves in an emergency.

  Yes

  No

  N/A

• Staff can articulate what to do in a fire

  Yes

  No

  N/A

• Able to verbalize what they do in the event of an Active Shooter/Fire/Code

  Yes

  No

  N/A

SCORE

• Total

• Compliance Rate = Total # items compliant X 100

Additional Pictures / Comments

• Good

  Fair

  Poor

  N/A