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Overview
Complete
General Infection Control Audit Checklist
General Infection Control Audit Checklist
Inspection score
96.75%
Failed items
0
Created actions
1
Hospital Name
Metropolis Care
Conducted on

11th Oct, 2018

5:58 PM +08

Prepared by
Johnny Little
Location
Aurora, NE 68818 United States (40.80864421273223, -98.0379204972799)
Actions
1
SafetyCulture Staff created a Medium priority action for facilitiesteam@safetyculture.io
To do
11th Oct, 2018 7:05 PM +08
Microwave has a spill that needs to be cleaned.
Audit / Patient Kitchen / Breakroom
Microwave oven clean?
Audit
1
96.75%
Employee Hand Hygiene Compliance
Employees Monitored
Nurse Danielle
Hand Hygiene
100.00%
Sinks for hand hygiene are well stocked?
Yes
Alcohol hand rubs are well stocked?
Yes
Sinks are available in all areas as needed?
Yes
Alcohol hand rubs are available in patient's rooms?
Yes
Placement of alcohol hand rubs is compliant with safety?
Yes
Hand washing/hand hygiene is performed between patients?
Yes
Hand Hygiene reminder posters present?
Yes
Hand soap is available in all hand washing stations/bathrooms?
Yes
Clean Utility / Central Supply / Storage
88.89%
Clean linen cart is covered?
Yes
Clean linen cart has solid surface on bottom shelf?
Yes
Sink storage area empty and clean?
Yes
Thrash cans or waste basket are not overfilled or overflowing?
Yes
Ceiling tiles are not stained or wet?
Yes
Floors are clean?
Yes
Supplies are stored at least 6 inches off of the floor?
Yes
Air intake vents and diffusers are clean?
No
Notes
Dusty right now.
Is this section free of additional findings?
Yes
Patient Rooms
91.30%
Horizontal surfaces are clean?
Yes
Thrash cans or waste basket are not overfilled or overflowing?
Yes
Bathrooms are clean?
Yes
Hand hygiene products are available?
Yes
Soap and paper towels are available in each bathroom?
Yes
PPE's are available as needed?
Yes
Patient equipment is clean?
Yes
No visible soil on vertical surfaces?
Yes
Ceiling tiles are not discolored, wet, missing, or damaged?
Yes
Air intake vents and diffusers are clean?
Yes
Furniture (chairs, sleepers) are without tears or wear?
Yes
Mattress pad is without tears or puncture holes?
Yes
Floors are clean?
Yes
Sharp containers are no more than 3/4 full?
Yes
Dust not found in high places?
Yes
General area is dust free?
No
Notes
The previous patient also noticed the dust that gathered on a corner of the room.
Photos
REFERENCE: General area is dust free [This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections]
Foley catheters hanging and secured appropriately?
Yes
IV pumps and poles, feeding pumps etc. are clean?
Yes
There is no evidence of pest present?
No
Notes
I saw tiny cockroaches.
Clean / dirty linen handled appropropriatly?
Yes
No needles, syringes, medications within reach of the patient?
Yes
No signs of mildew or mold present?
Yes
Is this section free of additional findings?
Yes
Patient Kitchen / Breakroom
1
90.91%
Floors and walls clean?
Yes
Horizontal and vertical surfaces are clean?
Yes
Microwave oven clean?
No
Actions
To do
Microwave has a spill that needs to be cleaned.
Refrigerator clean and thawed of ice?
Yes
Under sink clean and without storage?
Yes
Patient refrigerator labeled for patient use only?
Yes
Temperature checks are documented with corrective action when temp is out of range?
Yes
Patient food is labeled appropriately with no expired food found?
Yes
Ice machine is clean?
Yes
There is no evidence of pest present?
Yes
Is this section free of additional findings?
Yes
Employee Kitchen / Breakroom
100.00%
Floors and walls clean?
Yes
Horizontal and vertical surfaces are clean?
Yes
Microwave oven clean?
Yes
Refrigerator clean and thawed of ice?
Yes
Under sink clean and without storage?
Yes
Employee food labeled and dated?
Yes
Temperature checks are documented with corrective action when temp is out of range?
Yes
Is this section free of additional findings?
Yes
General Unit / Nurses Station / Medication Room
100.00%
Unit/area generally clean (without dust, clutter or debris)?
Yes
Unused patient equipment/supplies are stored and handled appropriately?
Yes
Medication, specimens, and food are handled appropriately?
Yes
Biohazard trash is segregated from regular trash?
Yes
Clean linen is handled appropriately?
Yes
Dirty linen is handled appropriately?
Yes
All clean linen carts are covered?
Yes
Linen carts have a solid bottom shelf?
Yes
Needles and syringes are disposed of properly?
Yes
Out of date supplies are not present?
Yes
Infectious waste in red bag or container?
Yes
Clean items are not stored in soiled utility room?
Yes
Ceiling tiles are not discolored/ wet/ missing / damaged?
Yes
Lab supplies are not expired?
Yes
Nothing is stored under the sink and there is no sign of leaks?
Yes
Halls are uncluttered?
Yes
Respiratory hygiene available?
Yes
Restrooms clean?
Yes
Trash basket are not overflowing?
Yes
Biohazard symbol on door of biomedical waste storage?
Yes
Medication cart locked?
Yes
No artificial/acrylic nails use. Nails are no more than 1/4 inch above finger?
Yes
No personal lotion use.
Yes
Medication Room refrigerator is clean and without ice?
Yes
There are no expired products found(IV solutions, medications, reagents, nutritional supplement, sterile items, etc.)
Yes
Is this section free of additional findings?
Yes
Logs
100.00%
Crash cart checked daily?
Yes
Defibrillator checked daily
Yes
Narcotic counts documented every shift?
Yes
Temperature checked BID for vaccine / medication storage?
Yes
Daily refrigerators checks with corrective actions as needed?
Yes
Ice machine cleaning date / time stamped?
Yes
Glucose meter strips dated
Yes
Cidex monitoring Log complete?
Yes
Is this section free of additional findings.
Yes
Isolation Rooms
100.00%
Appropriate signage in place?
Yes
Supplies and PPE's available?
Yes
Trash and linen handled per policy?
Yes
Appropriate PPE's used by staff?
Yes
Door closed as appropriate?
Yes
Negative pressure is being supplied as required?
Yes
Patient and family instructed on isolation requirements?
Yes
Patient with proper attire when being transported?
Yes
Is this section free of additional findings?
Yes
Employee General Knowledge
100.00%
Employees know the procedure for blood exposure?
Yes
Personnel can locate their Infection Control Manual?
Yes
Personnel can locate their Exposure Control Plan?
Yes
Personnel can locate the blood spill kit?
Yes
Personnel can locate their spill kit for Cidex?
Yes
Employees can state the WHO's 5 moments of Hand Hygiene.
Yes
Dust not found in high places?
Yes
Is this section free of additional findings?
Yes
Soiled Linen / Dirty Utility Room
100.00%
Biohazard symbol on door of biomedical waste storage?
Yes
Boxes are stored at least 6 inches off of the floor?
Yes
Walls / floors are clean
Yes
Ceiling tiles are not discolored/ wet/ missing / damaged?
Yes
Dust not found in high places?
Yes
Is this section free of additional findings?
Yes
Patient Shower Room
100.00%
Shower clean?
Yes
Shower room clean and orderly?
Yes
Walls and floor are clean?
Yes
Ceiling tiles are not discolored/ wet/ missing / damaged?
Yes
Dust not found in high places?
Yes
Is this section free of additional findings?
Yes
Completion
Additional Comments
That one room on the second floor urgently needs cleaning.
Surveyor's Name and Signature
Johnny Little
11th Oct, 2018 6:07 PM +08
Photos