Western Hospital Infection Control Environment Audit

• Conducted on

  Date

• Prepared by

• Select date

  Date

• Ward

General Environment

• Adequate facilities for hand hygiene are available in all clinical areas

  Yes

  No

  N/A

• Bed frames are clean and free from dust

  Yes

  No

  N/A

• Patient Lockers are free of splashes, soil, film, dust, fingerprints and spillage

  Yes

  No

  N/A

• Chairs and stools are free of splashes, soil, film, dust, fingerprints and spillage

  Yes

  No

  N/A

• Tables are free of splashes, soil, film, dust, fingerprints and spillage

  Yes

  No

  N/A

• Lockers, chairs and tables are in good state of repair

  Yes

  No

  N/A

• Floors including edges and corners are free from dust and grit

  Yes

  No

  N/A

• All high and low surfaces are free of dust and grit

  Yes

  No

  N/A

• Curtains and blinds are free from stains, dust and cobwebs

  Yes

  No

  N/A

• There is evidence of an effective pre-planned program for curtain changes

  Yes

  No

  N/A

• Air vents are clean and free from excessive dust

  Yes

  No

  N/A

• Patient call bells are clean and free from debris

  Yes

  No

  N/A

• Patient audio visual systems are clean and free from debris, dust and marks

  Yes

  No

  N/A

• Workstation equipment in clinical areas are visibly clean e.g. Phones, computer keyboards

  Yes

  No

  N/A

• GENERAL ENVIRONMENT COMPLIANCE RATE

  Select 100% (14/14) 93% (13/14) 86% (12/14) 79% (11/14) 71% (10/14) 64% (9/14) 75% (8/14) 50% (7/14) 43% (6/14) 36% (5/14) 29% (4/14) 21% (3/14) 14% (2/14) 7% (1/14) 0% (0/14)

  • 100% (14/14)
  • 93% (13/14)
  • 86% (12/14)
  • 79% (11/14)
  • 71% (10/14)
  • 64% (9/14)
  • 75% (8/14)
  • 50% (7/14)
  • 43% (6/14)
  • 36% (5/14)
  • 29% (4/14)
  • 21% (3/14)
  • 14% (2/14)
  • 7% (1/14)
  • 0% (0/14)

Clinical/treatment room/clean store

• There is an identified area for the storage of clean and sterile equipment

  Yes

  No

  N/A

• The area is clean and there are no inappropriate items of equipment

  Yes

  No

  N/A

• Hand hygiene equipment is available in the clinical/treatment room

  Yes

  No

  N/A

• Floors including edges and corners are free from dust and grit

  Yes

  No

  N/A

• All high and low surfaces are free from dust and cobwebs

  Yes

  No

  N/A

• Shelves, bench tops and cupboards are clean inside and out, and are free of dust and spillage

  Yes

  No

  N/A

• All products are stored above floor level

  Yes

  No

  N/A

• CLINICAL/TREATMENT ROOM/CLEAN STORE COMPLIANCE RATE

  Select 100% (7/7) 86% (6/7) 71% (5/7) 57% (4/7) 43% (3/7) 29% (2/7) 14% (1/7) 0% (0/7)

  • 100% (7/7)
  • 86% (6/7)
  • 71% (5/7)
  • 57% (4/7)
  • 43% (3/7)
  • 29% (2/7)
  • 14% (1/7)
  • 0% (0/7)

Bathrooms

• Bathrooms are clean

  Yes

  No

  N/A

• Bathrooms are not used for equipment storage

  Yes

  No

  N/A

• Showers, Baths, sinks and accessories are clean

  Yes

  No

  N/A

• Wall tiles and wall fixtures are clean and free from mould

  Yes

  No

  N/A

• Shower curtains are free from mould, clean and dry

  Yes

  No

  N/A

• There is evidence that showers, baths and sinks taken out of use have planned provision for running water weekly

  Yes

  No

  N/A

• Floors including edges and corners are free from dust and grit

  Yes

  No

  N/A

• BATHROOMS COMPLIANCE RATE

  Select 100% (7/7) 86% (6/7) 71% (5/7) 57% (4/7) 43% (3/7) 29% (2/7) 14% (1/7) 0% (0/7)

  • 100% (7/7)
  • 86% (6/7)
  • 71% (5/7)
  • 57% (4/7)
  • 43% (3/7)
  • 29% (2/7)
  • 14% (1/7)
  • 0% (0/7)

Toilets

• The toilet, hand wash sink, handrails and surrounding area is clean and free from extraneous items

  Yes

  No

  N/A

• Floors including edges and corners are free from dust and grit

  Yes

  No

  N/A

• Hand washing facilities are available including soap and paper towels

  Yes

  No

  N/A

• There is a facility for sanitary waste disposal

  Yes

  No

  N/A

• TOILETS COMPLIANCE RATE

  100% (4/4)

  75% (3/4)

  50% (2/4)

  25% (1/4)

  0% (0/4)

Dirty utility

• A dirty utility is available

  Yes

  No

  N/A

• A separate sink is available for decontamination of patient equipment

  Yes

  No

  N/A

• A sluice hopper is available for the disposal of body fluids

  Yes

  No

  N/A

• The integrity of fixtures and fittings are intact

  Yes

  No

  N/A

• Separate hand washing facilities are available including soap and water

  Yes

  No

  N/A

• The room is clean and free from inappropriate items

  Yes

  No

  N/A

• The floor is clean and free from spillage

  Yes

  No

  N/A

• Floors including edges and corners are free from dust and grit

  Yes

  No

  N/A

• Bed pan flusher is in working order

  Yes

  No

  N/A

• Shelves and cupboards are clean inside and out and free from dust, litter or stains

  Yes

  No

  N/A

• DIRTY UTILIY COMPLIANCE RATE

  Select 100% (10/10) 90% (9/10) 80% (8/10) 70% (7/10) 60% (6/10) 50% (5/10) 40% (4/10) 30% (3/10) 20% (2/10) 10% (1/10) 0% (0/10)

  • 100% (10/10)
  • 90% (9/10)
  • 80% (8/10)
  • 70% (7/10)
  • 60% (6/10)
  • 50% (5/10)
  • 40% (4/10)
  • 30% (3/10)
  • 20% (2/10)
  • 10% (1/10)
  • 0% (0/10)

Cleaners room

• Floors including edges and corners are free from dust and grit

  Yes

  No

  N/A

• Equipment used by the integrated services staff is clean, well maintained and stored in a locked area

  Yes

  No

  N/A

• Machines used by integrated services staff for floor cleaning are clean and dry

  Yes

  No

  N/A

• No inappropriate materials or equipment are stored in the cleaner's room

  Yes

  No

  N/A

• Products used for cleaning and disinfection comply with policy and are used at the correct dilution

  Yes

  No

  N/A

• Personal protection equipment is available and appropriately used

  Yes

  No

  N/A

• Information on the colour coding system for cleaning equipment in use is available in the cleaner's room

  Yes

  No

  N/A

• Hand hygiene facilities are available for cleaners use

  Yes

  No

  N/A

• CLEANERS ROOM COMPLIANCE RATE

  Select 100% (8/8) 86% (7/8) 75% (6/8) 63% (5/8) 50% (4/8) 36% (3/8) 25% (2/8) 13% (1/8) 0% (0/8)

  • 100% (8/8)
  • 86% (7/8)
  • 75% (6/8)
  • 63% (5/8)
  • 50% (4/8)
  • 36% (3/8)
  • 25% (2/8)
  • 13% (1/8)
  • 0% (0/8)

OVERALL COMPLIANCE

• Compliance total out of 50

• OVERALL COMPLIANCE ACHEIVED

  Select 100% (50/50) 98% (49/50) 96% (48/50) 94% (47/50) 92% (46/50) 90% (45/50) 88% (44/50) 86% (43/50) 84% (42/50) 82% (41/50) 80% (40/50) 78% (39/50) 76% (38/50) 74% (37/50) 72% (36/50) 70% (35/50) 68% (34/50) 66% (33/50) 64% (32/50) 62% (30/50) 60% (28/50) 58% (27/50) 56% (26/50) 50% (25/50) 48% (24/50) 46% (23/50) 44% (22/50) 42% (21/50) 40% (20/50) 38% (19/50) 36% (18/50) 34% (17/50) 32% (16/50) 30% (15/50) 28% (14/50) 26% (13/50) 24% (12/50) 22% (11/50) 20% (10/50) 18% (9/50) 16% (8/50) 14% (7/50) 12% (6/50) 10% (5/50) 8% (4/50) 6% (3/50) 4% (2/50) 2% (1/50) 0% (0/50)

  • 100% (50/50)
  • 98% (49/50)
  • 96% (48/50)
  • 94% (47/50)
  • 92% (46/50)
  • 90% (45/50)
  • 88% (44/50)
  • 86% (43/50)
  • 84% (42/50)
  • 82% (41/50)
  • 80% (40/50)
  • 78% (39/50)
  • 76% (38/50)
  • 74% (37/50)
  • 72% (36/50)
  • 70% (35/50)
  • 68% (34/50)
  • 66% (33/50)
  • 64% (32/50)
  • 62% (30/50)
  • 60% (28/50)
  • 58% (27/50)
  • 56% (26/50)
  • 50% (25/50)
  • 48% (24/50)
  • 46% (23/50)
  • 44% (22/50)
  • 42% (21/50)
  • 40% (20/50)
  • 38% (19/50)
  • 36% (18/50)
  • 34% (17/50)
  • 32% (16/50)
  • 30% (15/50)
  • 28% (14/50)
  • 26% (13/50)
  • 24% (12/50)
  • 22% (11/50)
  • 20% (10/50)
  • 18% (9/50)
  • 16% (8/50)
  • 14% (7/50)
  • 12% (6/50)
  • 10% (5/50)
  • 8% (4/50)
  • 6% (3/50)
  • 4% (2/50)
  • 2% (1/50)
  • 0% (0/50)

• Overall compliance rate is greater than 90% which ensures that the environment been maintained appropriately to reduce the risk of cross infection?

  YES

  NO

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