TSDHCT IPS Site Audits V1.1

• Document No.

• IPS Environmental Audit

• Client / Site - Please enter the name of the community site you are auditing.

• Conducted on

  Date

• Prepared by - The Community Infection Prevention and Control Team

• Location
  Address

• Personnel - Please enter the name of the person carrying out the audit.

Hand Hygiene - General

• The organisation has comprehensive procedures and policy for hand hygiene?

  Yes

  No

  N/A

• Organisational structures are in place to ensure distribution, compliance and monitoring of the hand hygiene policy and procedures?

  Yes

  No

  N/A

• Hand hygiene is an integral part of induction for all staff?

  Yes

  No

  N/A

• Staff have received training in hand hygiene procedures? (Ask a member of staff)

  Yes

  No

  N/A

• Clinical staff nails are short, clean and free from extensions and varnish?

  Yes

  No

  N/A

• No wrist watches, stoned rings or other wrist jewellery are worn during clinical procedures?

  Yes

  No

  N/A

• Hand hygiene is encouraged and alcohol hand rubs are made available for visitors?

  Yes

  No

  N/A

• Posters promoting hand hygiene are available and are on display?

  Yes

  No

  N/A

• There is a hand wash basin in each treatment / clinical area?

  Yes

  No

  N/A

• Hand washing facilities are clean and intact? (Check sinks, taps, splash backs, soap and towel dispensers)

  Yes

  No

  N/A

• Hand wash basins are dedicated for that use only and are free from used equipment and inappropriate items?

  Yes

  No

  N/A

• There is easy access to the hand wash basin?

  Yes

  No

  N/A

• The hand wash basin complies with HTM 64, I.e. No plugs, no overflows, water from the taps not directly situated over the plug hole?

  Yes

  No

  N/A

• Elbow operated taps are available at all hand wash basins in clinical areas?

  Yes

  No

  N/A

• Liquid soap is available at each hand wash basin?

  Yes

  No

  N/A

• Liquid soap is available in the form of single use cartridge dispensers?

  Yes

  No

  N/A

• There is no bar soap at hand wash basins in treatment / clinical areas?

  Yes

  No

  N/A

• Alcohol rub is a viable for use at the entrance / exits to clinical settings, where appropriate, e.g. Community hospitals?

  Yes

  No

  N/A

• Portable hand rub is available for domiciliary visits?

  Yes

  No

  N/A

• Clinical staff are encouraged to use hand moisturisers that are pump operated for personal use?

  Yes

  No

  N/A

• Soft absorbent paper towels are available at all hand washing sinks?

  Yes

  No

  N/A

• There are no reusable cotton towels used to dry hands?

  Yes

  No

  N/A

• There are no reusable nail brushes used

  Yes

  No

  N/A

• There is a foot operated bin for waste towels in close proximity to hand washing sinks which are fully operational?

  Yes

  No

  N/A

MIU / Outpatients - Environment

• Organisational structures are in place to ensure distribution, compliance and auditing of cleanliness?

  Yes

  No

  N/A

• Overall appearance of the environment is tidy and uncluttered with only appropriate, clean and well maintained furniture used?

  Yes

  No

  N/A

• Fabric of the environment and equipment smells clean, fresh and pleasant?

  Yes

  No

  N/A

• The allocation of rooms for clinical practice is fit for purpose?

  Yes

  No

  N/A

• Rooms where clinical practice takes place are not carpeted?

  Yes

  No

  N/A

• Floor coverings are washable and impervious to moisture and are sealed regularly?

  Yes

  No

  N/A

• The complete floor, including edges and corners are visibly clean with no visible body substances, dust, dirt or debris?

  Yes

  No

  N/A

• Furniture, fixtures and fittings should be visibly clean with no body substances, dust, debris or adhesive tape?

  Yes

  No

  N/A

• All dispensers, holders and all parts of the surfaces of dispensers of soap and alcohol gels, paper towel / couch roll / toilet paper holders are visibly clean with no body substances, dust, dirt, debris or adhesive tape?

  Yes

  No

  N/A

• Toilets are visibly clean with no body substances, dust, lime scale stains, deposits or smears - including underneath toilet seat?

  Yes

  No

  N/A

• Hand wash basins are visibly clean with no body substances, dust, lime scale stains, deposits or smears?

  Yes

  No

  N/A

• Hand wash basins are dedicated for that use only and are free from used equipment and inappropriate items?

  Yes

  No

  N/A

• Facilities are available for the safe disposal of sanitary towels?

  Yes

  No

  N/A

• Sanitary bins are replaced regularly with clean to prevent overfilling?

  Yes

  No

  N/A

• Waste receptacles are clean, including lid and pedal?

  Yes

  No

  N/A

• Foot pedals of clinical waste bins are in good working order?

  Yes

  No

  N/A

• There is a procedure in place for regular decontamination of curtains and blinds?

  Yes

  No

  N/A

• Furniture in patient areas e.g. Chairs and couches are made from impermeable and washable materials?

  Yes

  No

  N/A

• Chairs are free from rips and tears?

  Yes

  No

  N/A

• Couches are free from rips and tears?

  Yes

  No

  N/A

• Disposable paper couch roll is in use on examination couches?

  Yes

  No

  N/A

• Pillows are enclosed in a washable and impervious cover?

  Yes

  No

  N/A

• Furniture that cannot be cleaned is condemned?

  Yes

  No

  N/A

• Tables are tidy and uncluttered to enable cleaning?

  Yes

  No

  N/A

• Medical equipment is cleaned, maintained and stored appropriately?

  Yes

  No

  N/A

• Water coolers are mains supplied, visibly clean and on a planned maintenance programme?

  Yes

  No

  N/A

• Soft toys are not available for communal use?

  Yes

  No

  N/A

• Toys are visibly clean with no evidence of body substances, dust or deposits?

  Yes

  No

  N/A

• Changing mats are free from rips and tears and are visibly clean with no evidence of body substances, dust or debris?

  Yes

  No

  N/A

• Changing mats are covered in an easy clean material?

  Yes

  No

  N/A

• Baby weighing scales are visibly clean with no body substances, dust or debris?

  Yes

  No

  N/A

• Sharps bins / boxes are clearly and correctly labelled?

  Yes

  No

  N/A

• Sharps bins / boxes are not overfilled and do not have any objects protruding?

  Yes

  No

  N/A

• Sharps bins / boxes are in a closed position?

  Yes

  No

  N/A

Physiotherapy - Environment

• Organisational structures are in place to ensure distribution, compliance and auditing of cleanliness?

  Yes

  No

  N/A

• Overall appearance of the environment is tidy and uncluttered with only appropriate, clean and well maintained furniture used?

  Yes

  No

  N/A

• Fabric of the environment and equipment smells clean, fresh and pleasant?

  Yes

  No

  N/A

• The allocation of rooms for clinical practice is fit for purpose?

  Yes

  No

  N/A

• Rooms where clinical practice takes place are not carpeted?

  Yes

  No

  N/A

• Floor coverings are washable, impervious to moisture and sealed regularly?

  Yes

  No

  N/A

• Yes

  No

  N/A

• The complete floor, including edges and corners are visibly clean, with no visible body substances, dust, dirt or debris?

  Yes

  No

  N/A

• Furniture, fixtures and fittings should be visibly clean with no body substances, dust, dirt, debris or adhesive tape?

  Yes

  No

  N/A

• All dispensers, holders and all parts of the surfaces of dispensers of soap and alcohol gels, paper towel / couch roll / toilet paper holders are visibly clean with no body substances, dust, dirt, debris, or adhesive tape?

  Yes

  No

  N/A

• Toilets are visibly clean with no body substances, dust, lime scale stains, deposits or smears - including under the toilet seat?

  Yes

  No

  N/A

• Hand wash basins are visibly clean with no body substances, dust, lime scale stains, deposits or smears?

  Yes

  No

  N/A

• Hand wash basins are dedicated for that use only and are free from used equipment and inappropriate items?

  Yes

  No

  N/A

• Facilities are available for the safe disposal of sanitary towels?

  Yes

  No

  N/A

• Sanitary bins are replaced regularly with clean to prevent overfilling?

  Yes

  No

  N/A

• Waste receptacles are clean, including lid and pedal?

  Yes

  No

  N/A

• Foot pedals of clinical waste bins are in good working order?

  Yes

  No

  N/A

• There is a procedure in place for regular decontamination of curtains and blinds?

  Yes

  No

  N/A

• Furniture in patient areas e.g. Chairs and couches are made of impermeable and washable materials?

  Yes

  No

  N/A

• Chairs are free from rips and tears?

  Yes

  No

  N/A

• Couches are free from rips and tears?

  Yes

  No

  N/A

• Disposable paper couch roll is in use on examination couches?

  Yes

  No

  N/A

• Pillows are enclosed in a washable and impervious cover?

  Yes

  No

  N/A

• Furniture that cannot be cleaned is condemned?

  Yes

  No

  N/A

• Tables are tidy and uncluttered to enable cleaning?

  Yes

  No

  N/A

• Medical equipment is cleaned, maintained and stored appropriately?

  Yes

  No

  N/A

• Water coolers are mains supplied, visibly clean and on a planned maintenance programme?

  Yes

  No

  N/A

• Soft toys are not available for communal use?

  Yes

  No

  N/A

• Toys are visibly clean with no evidence of body substances, dust or debris?

  Yes

  No

  N/A

• Changing mats are free from rips and tears and are visibly clean with no evidence of body substances, dust or deposits?

  Yes

  No

  N/A

• Changing mats are covered in an easy clean material?

  Yes

  No

  N/A

• Baby weighing scales are visibly clean with no body substances, dust or deposits?

  Yes

  No

  N/A

• Sharps bins / boxes are clearly and correctly labelled?

  Yes

  No

  N/A

• Sharps bins / boxes are not overfilled and do not have any objects protruding?

  Yes

  No

  N/A

• Sharps bins / boxes are in a closed position?

  Yes

  No

  N/A

OT Kitchen - Environment and Kitchen

• Organisational structures are in place to ensure distribution, compliance and auditing of cleanliness?

  Yes

  No

  N/A

• Overall appearance of the environment is tidy and uncluttered with only appropriate, clean and well maintained furniture used?

  Yes

  No

  N/A

• Fabric of the environment and equipment mills clean, fresh and pleasant?

  Yes

  No

  N/A

• The allocation of rooms for clinical practice is fit for purpose?

  Yes

  No

  N/A

• Rooms where clinical practice takes place are not carpeted?

  Yes

  No

  N/A

• Floor coverings are washable and impervious to moisture and are sealed regularly?

  Yes

  No

  N/A

• The complete floor, including edges and corners are visibly clean with no visible body substances, dust, debris or adhesive tape?

  Yes

  No

  N/A

• Furniture, fixtures and fittings should be visibly clean with no body substances, dust, dirt, debris or adhesive tape?

  Yes

  No

  N/A

• All dispensers, holders and all parts of the surfaces of dispensers or soap and alcohol gels, paper towels / couch roll / toilet paper holders are visibly clean with no body substances, dust, dirt, debris or adhesive tape?

  Yes

  No

  N/A

• Hand wash basins are visibly clean with no body substances, dust, lime scale stains, deposits or smears?

  Yes

  No

  N/A

• Hand wash basins are dedicated for that use only and are free from used equipment and inappropriate items?

  Yes

  No

  N/A

• Waste receptacles are clean, including lid and pedal?

  Yes

  No

  N/A

• Foot pedals of clinical waste bins are in good working order?

  Yes

  No

  N/A

• Furniture in patient areas e.g. Chairs and couches are made of impermeable and washable materials?

  Yes

  No

  N/A

• Chairs are free from rips and tears?

  Yes

  No

  N/A

• Couches are free from rips and tears?

  Yes

  No

  N/A

• Furniture that cannot be cleaned is condemned?

  Yes

  No

  N/A

• Tables are tidy and uncluttered to enable cleaning?

  Yes

  No

  N/A

• Medical equipment is cleaned, maintained and stored appropriately?

  Yes

  No

  N/A

• Water coolers are mains supplied, visibly clean and on a planned maintenance programme?

  Yes

  No

  N/A

• The kitchen floor is clean and dry?

  Yes

  No

  N/A

• There is no evidence of infestation or animals in the kitchen?

  Yes

  No

  N/A

• Cleaning materials used in the kitchen are clearly identifiable and are stored separately to other cleaning equipment and away from food?

  Yes

  No

  N/A

• There is a separate dedicated hand wash sink and liquid soap and paper towels are available?

  Yes

  No

  N/A

• Fixtures and fittings are in a good state of repair?

  Yes

  No

  N/A

• Fixtures, surfaces and appliances are clean and dry?

  Yes

  No

  N/A

• Shelves, cupboards and drawers are clean and dry, free from dust and in a good state of repair?

  Yes

  No

  N/A

• All cooking appliances are visibly clean?

  Yes

  No

  N/A

• Refrigerators / freezers are clean and free from ice build up?

  Yes

  No

  N/A

• There is a thermometer in the refrigerator / freezer?

  Yes

  No

  N/A

• There is evidence that daily temperatures are recorded and appropriate action is taken if standards are not met? (refrigerator temperature must be less than 8 degrees C, freezer -18 degrees C or as per local policy)

  Yes

  No

  N/A

• Patient and staff food is labelled and there is a system in place to determine when it was opened and / or when it should be used by?

  Yes

  No

  N/A

• There are no inappropriate items ( e.g. Medications or specimens) in the refrigerator?

  Yes

  No

  N/A

• Milk is stored in the refrigerator?

  Yes

  No

  N/A

• Bread is stored in a clean and dry container?

  Yes

  No

  N/A

• All food products are within their expiry dates?

  Yes

  No

  N/A

• Opened food is covered or stored in containers?

  Yes

  No

  N/A

• Water coolers / ice machines are mains supplied, visibly clean and on a planned maintenance programme?

  Yes

  No

  N/A

• Ice making machines that use storage bins for storing ice in the ice maker are not in use?

  Yes

  No

  N/A

• Ice dispensing machines are used where ice is required for food / drink purposes? (I.e. The ice is dispensed from nozzles directly into a receptacle on demand)

  Yes

  No

  N/A

• The daily routine of the ice maker / dispenser is strictly adhered to and is cleaned at least once a week according to manufacture instructions?

  Yes

  No

  N/A

• Disposable paper roll is available for drying equipment and surfaces?

  Yes

  No

  N/A

• There are no fabric tea towels or dishcloths in use?

  Yes

  No

  N/A

• Waste bins are foot operated, clean and in good working order?

  Yes

  No

  N/A

• There are no inappropriate items or equipment in the kitchen?

  Yes

  No

  N/A

Kitchen - Kitchen

• The kitchen is subject to a regular inspection from environmental health or other agency?

  Yes

  No

  N/A

• The floor is clean and dry?

  Yes

  No

  N/A

• There is no evidence of infestation or animals in the kitchen?

  Yes

  No

  N/A

• Fly screens are in place where required?

  Yes

  No

  N/A

• Cleaning materials used in the kitchen are identifiable and are stored separately to other cleaning equipment and away from food?

  Yes

  No

  N/A

• There is a separate dedicated hand wash sink and liquid soap and paper towels are available?

  Yes

  No

  N/A

• Fixtures and fittings are in a good state of repair?

  Yes

  No

  N/A

• Fixtures, surfaces and appliances are clean and dry?

  Yes

  No

  N/A

• Shelves, cupboards and drawers are clean and dry, free from dust and in a good state of repair?

  Yes

  No

  N/A

• All cooking appliances are visibly clean?

  Yes

  No

  N/A

• Refrigerators / freezers are clean and free from ice build up?

  Yes

  No

  N/A

• There is a thermometer in the refrigerator and freezer?

  Yes

  No

  N/A

• There is evidence that daily temperatures are recorded and appropriate action is taken if standards are not met? ( refrigerator temperature must be less than 8 degrees C, freezer -18 degrees C or as per local policy

  Yes

  No

  N/A

• Patient and staff food is labelled and there is a system in place to determine when it was opened and / or when it should be used by?

  Yes

  No

  N/A

• There Re no inappropriate items (e.g. Medications or specimens) in the refrigerator?

  Yes

  No

  N/A

• Milk is stored in the refrigerator?

  Yes

  No

  N/A

• Bread is stored in a clean and dry container?

  Yes

  No

  N/A

• All food products are within their expiry dates?

  Yes

  No

  N/A

• Opened food is covered or stored in containers?

  Yes

  No

  N/A

• Water coolers / ice machines are mains supplied, visibly clean and on a planned maintenance programme?

  Yes

  No

  N/A

• Ice making machines that use storage bins for storing ice in the ice maker are not in use?

  Yes

  No

  N/A

• Ice dispensing machines are used where ice is required for food / drink purposes? (I.e. The ice is dispensed from nozzles directly into a receptacle on demand)

  Yes

  No

  N/A

• The daily routine of the ice maker / dispenser is strictly adhered to and is cleaned at least once a week according to manufacturers instructions?

  Yes

  No

  N/A

• There is a satisfactory system for cleaning crockery and cutlery e.g. Dishwasher which is clean and well maintained?

  Yes

  No

  N/A

• Disposable paper roll is available for drying equipment and surfaces?

  Yes

  No

  N/A

• There are no fabric tea towels or dish cloths in use?

  Yes

  No

  N/A

• Waste bins are foot operated, clean and in good working order?

  Yes

  No

  N/A

• There are no inappropriate items or equipment in the kitchen?

  Yes

  No

  N/A

Ward One - Environment

• Ward Name

• Organisational structures are in place to ensure distribution, compliance and auditing of cleanliness?

  Yes

  No

  N/A

• Overall appearance of the environment is tidy and uncluttered with only appropriate clean and well maintained furniture used?

  Yes

  No

  N/A

• Fabric of the environment and equipment smells clean, fresh and pleasant?

  Yes

  No

  N/A

• The allocation of rooms for clinical practice is fit for purpose?

  Yes

  No

  N/A

• Rooms where clinical practice takes place are not carpeted?

  Yes

  No

  N/A

• Floor coverings are washable and impervious to moisture and sealed regularly?

  Yes

  No

  N/A

• The complete floor, including edges and corners are visibly clean with no visible body substances, dust, dirt or debris?

  Yes

  No

  N/A

• Furniture, fixtures and fittings should be visibly clean with no body substances, dust, dirt, debris or adhesive tape?

  Yes

  No

  N/A

• All dispensers, holders and all parts of the surfaces of dispensers of soap and alcohol gels, paper towel / couch roll / toilet paper holders are visibly clean with no body substances, dust, dirt, debris or adhesive tape?

  Yes

  No

  N/A

• Toilets are visibly clean with no body substances, dust, lime scale stains, deposits or smears - including underneath the toilet seat?

  Yes

  No

  N/A

• Hand wash basins are visibly clean with no body substances, dust, lime scale stains, deposits or smears?

  Yes

  No

  N/A

• Hand wash basins are dedicated for that use only and are free from equipment and inappropriate items?

  Yes

  No

  N/A

• Facilities are available for the safe disposal of sanitary towels?

  Yes

  No

  N/A

• Sanitary bins are replaced regularly with new to prevent overfilling?

  Yes

  No

  N/A

• Waste receptacles are clean, including lid and pedal?

  Yes

  No

  N/A

• Foot pedals of clinical waste bins are in good working order?

  Yes

  No

  N/A

• There is a procedure in place for regular decontamination of curtains and blinds?

  Yes

  No

  N/A

• Furniture in patient areas e.g. Chairs and couches are made of impermeable and washable materials?

  Yes

  No

  N/A

• Chairs are free from rips and tears?

  Yes

  No

  N/A

• Couches are free from rips and tears?

  Yes

  No

  N/A

• Disposable paper couch roll is in use on examination couches?

  Yes

  No

  N/A

• Pillows are enclosed in a washable and impervious cover?

  Yes

  No

  N/A

• Furniture that cannot e cleaned is condemned?

  Yes

  No

  N/A

• Tables are tidy and uncluttered to enable cleaning?

  Yes

  No

  N/A

• Medical equipment is cleaned, maintained and stored appropriately?

  Yes

  No

  N/A

• Water coolers are mains supplied, visibly clean and on a planned maintenance programme?

  Yes

  No

  N/A

• Soft toys are not available for communal use?

  Yes

  No

  N/A

• Toys are visibly clean with no evidence of body substances, dust or deposits?

  Yes

  No

  N/A

• Changing mats are free from rips and tears and are visibly clean with no evidence of body substances, dust or deposits?

  Yes

  No

  N/A

• Changing mats are covered in an easy clean material?

  Yes

  No

  N/A

• Sharps bins / boxes are clearly and correctly labelled?

  Yes

  No

  N/A

• Sharps bins / boxes are in a closed position?

  Yes

  No

  N/A

• Sharps bins / boxes are not overfilled or have any objects protruding?

  Yes

  No

  N/A

Ward Two - Environment

• Ward Name

• Organisational structures are in place to ensure distribution, compliance and auditing of cleanliness?

  Yes

  No

  N/A

• Overall appearance of the environment is tidy and uncluttered with only appropriate, clean and well maintained furniture used?

  Yes

  No

  N/A

• Fabric of the environment and equipment smells clean, fresh and pleasant?

  Yes

  No

  N/A

• The allocation of rooms for clinical practice is fit for purpose?

  Yes

  No

  N/A

• Rooms where clinical practice takes place are not carpeted?

  Yes

  No

  N/A

• Floor coverings are washable, impervious to moisture and sealed regularly?

  Yes

  No

  N/A

• The complete floor, including edges and corners are visibly clean, with no visible body substances, dust, dirt or debris?

  Yes

  No

  N/A

• Furniture, fixture and fittings should be visibly clean with no body substances, dust, dirt, debris or adhesive tape?

  Yes

  No

  N/A

• All dispensers, holders and all parts of dispensers of soap and alcohol gels, paper towel / couch roll / toilet paper holders are visibly clean with no body substances, dust, dirt, debris or adhesive tape?

  Yes

  No

  N/A

• Toilets are visibly clean with no body substances, dust, lime scale stains, deposits or smears - including underneath the toilet seat?

  Yes

  No

  N/A

• Hand wash basins are visibly clean with no body substances, dust, lime scale stains, deposits or smears?

  Yes

  No

  N/A

• Hand wash basins are dedicated for that use only and are free from used equipment and inappropriate items?

  Yes

  No

  N/A

• Facilities are available for the safe disposal of sanitary towels?

  Yes

  No

  N/A

• Sanitary bins are replaced regularly with clean to prevent overfilling?

  Yes

  No

  N/A

• Waste receptacles are clean, including lid and pedal?

  Yes

  No

  N/A

• Foot pedals of clinical waste bins are in good working order?

  Yes

  No

  N/A

• There is a procedure in place for regular decontamination of curtains and blinds?

  Yes

  No

  N/A

• Furniture in patient areas e.g. Chairs and couches are made from impervious and washable materials?

  Yes

  No

  N/A

• Chairs are free from rips and tears?

  Yes

  No

  N/A

• Couches are free from rips and tears?

  Yes

  No

  N/A

• Disposable paper couch roll is in use on examination couches?

  Yes

  No

  N/A

• Pillows are enclosed in a washable and impervious cover?

  Yes

  No

  N/A

• Furniture that cannot be cleaned is condemned?

  Yes

  No

  N/A

• Tables are tidy and uncluttered to enable cleaning?

  Yes

  No

  N/A

• Medical equipment is cleaned, maintained and stored appropriately?

  Yes

  No

  N/A

• Water coolers are mains supplied, visibly clean and on a planned maintenance programme?

  Yes

  No

  N/A

• Soft toys are not available for communal use?

  Yes

  No

  N/A

• Toys are visibly clean with no evidence of body substances, dust or deposits?

  Yes

  No

  N/A

• Changing mats are free from rips and tears, and are visibly clean, with no evidence of body substances, dust, or deposits?

  Yes

  No

  N/A

• Changing mats are covered in an easy clean material?

  Yes

  No

  N/A

• Sharps bins / boxes are clearly and correctly labelled?

  Yes

  No

  N/A

• Sharps bins / boxes are not overfilled and do not have any objects protruding?

  Yes

  No

  N/A

• Sharps bins / boxes are in a closed position?

  Yes

  No

  N/A

MRSA Screening - Screening Compliance

Patient One

• Has the MRSA screen been carried out and is it clearly documented in patient one's notes?

  Yes

  No

  N/A

Patient Two

• Has the MRSA screen been carried out and is it clearly documented in patient two's notes?

  Yes

  No

  N/A

Patient Three

• Has the MRSA screen been carried out and is it clearly documented in patient three's notes?

  Yes

  No

  N/A

Saving Lives - Catheter Ongoing Care

Patient One

• Hand Hygiene?

  Yes

  No

  N/A

• Catheter Hygiene?

  Yes

  No

  N/A

• Aseptic Sampling?

  Yes

  No

  N/A

• Drainage bag position?

  Yes

  No

  N/A

• Catheter manipulation?

  Yes

  No

  N/A

• Catheter needed?

  Yes

  No

  N/A

Patient Two

• Hand Hygiene?

  Yes

  No

  N/A

• Catheter Hygiene?

  Yes

  No

  N/A

• Aseptic Sampling?

  Yes

  No

  N/A

• Drainage bag position?

  Yes

  No

  N/A

• Catheter manipulation?

  Yes

  No

  N/A

• Catheter needed?

  Yes

  No

  N/A

Patient Three

• Hand Hygiene?

  Yes

  No

  N/A

• Catheter Hygiene?

  Yes

  No

  N/A

• Aseptic Sampling?

  Yes

  No

  N/A

• Drainage bag position?

  Yes

  No

  N/A

• Catheter manipulation?

  Yes

  No

  N/A

• Catheter needed?

  Yes

  No

  N/A

Saving Lives - Cannula Ongoing Care

Patient One

• Hand Hygiene?

  Yes

  No

  N/A

• Continuing clinical evaluation?

  Yes

  No

  N/A

• Site inspected?

  Yes

  No

  N/A

• Dressing?

  Yes

  No

  N/A

• Cannula access?

  Yes

  No

  N/A

• Administration set replacement?

  Yes

  No

  N/A

• Routine cannula replacement?

  Yes

  No

  N/A

Patient Two

• Hand Hygiene?

  Yes

  No

  N/A

• Continuing clinical evaluation?

  Yes

  No

  N/A

• Site inspected?

  Yes

  No

  N/A

• Dressing?

  Yes

  No

  N/A

• Cannula access?

  Yes

  No

  N/A

• Administration set replacement?

  Yes

  No

  N/A

• Routine cannula replacement?

  Yes

  No

  N/A

Patient Three

• Hand Hygiene?

  Yes

  No

  N/A

• Continuing clinical evaluation?

  Yes

  No

  N/A

• Site inspected?

  Yes

  No

  N/A

• Dressing?

  Yes

  No

  N/A

• Cannula access?

  Yes

  No

  N/A

• Administration set replacement?

  Yes

  No

  N/A

• Routine cannula replacement?

  Yes

  No

  N/A

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