Information

  • Audit Title

  • Conducted on

  • Prepared by

  • Personnel

Cath Lab 1

  • Procedure room surface counters, cabinets, and all surfaces are clean and free of dust.

  • Procedure room furniture, metal tables, and carts are clean and dust free.

  • Procedural room lights are clean and dust free.

  • Procedure cart/bed is clean and free of dust, blood or body fluids.

  • Procedure room booms, cords, and hoses are free of dust, blood or other fluids/soiling.

  • The procedural floor is clean and free of soiling or blood and body fluids.

  • Procedural room trash and biohazardous waste has been removed and disposed of properly.

  • All soiled linen has been removed from procedural room.

  • Vents are free of dust and debris.

Cath Lab 2

  • Procedure room surface counters, cabinets, and all surfaces are clean and free of dust.

  • Procedure room furniture, metal tables, and carts are clean and dust free.

  • Procedural room lights are clean and dust free.

  • Procedure cart/bed is clean and free of dust, blood or body fluids.

  • Procedure room booms, cords, and hoses are free of dust, blood or other fluids/soiling.

  • The procedural floor is clean and free of soiling or blood and body fluids.

  • Procedural room trash and biohazardous waste has been removed and disposed of properly.

  • All soiled linen has been removed from procedural room.

  • Vents are free of dust and debris.

Cath Lab 3

  • Procedure room surface counters, cabinets, and all surfaces are clean and free of dust.

  • Procedure room furniture, metal tables, and carts are clean and dust free.

  • Procedural room lights are clean and dust free.

  • Procedure cart/bed is clean and free of dust, blood or body fluids.

  • Procedure room booms, cords, and hoses are free of dust, blood or other fluids/soiling.

  • The procedural floor is clean and free of soiling or blood and body fluids.

  • Procedural room trash and biohazardous waste has been removed and disposed of properly.

  • All soiled linen has been removed from procedural room.

  • Vents are free of dust and debris.

Cath Lab 4

  • Procedure room surface counters, cabinets, and all surfaces are clean and free of dust.

  • Procedure room furniture, metal tables, and carts are clean and dust free.

  • Procedural room lights are clean and dust free.

  • Procedure cart/bed is clean and free of dust, blood or body fluids.

  • Procedure room booms, cords, and hoses are free of dust, blood or other fluids/soiling.

  • The procedural floor is clean and free of soiling or blood and body fluids.

  • Procedural room trash and biohazardous waste has been removed and disposed of properly.

  • All soiled linen has been removed from procedural room.

  • Vents are free of dust and debris.

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