Environment of care rounds checklist
Patient safety management
What does this form include?
This form contains 3 sections:
PATIENT SAFETY – Margie Martin, Risk Manager & Tricia Heimbigner, Employee Health Manager
- Area is free of patient slip/fall risks.
- No patient contact items or paper goods are stored under sinks.
- Wastebaskets are of fire resistant construction.
- Patient records properly secured and not left unsupervised on a computer monitor.
- Crash carts are locked, with updated logged and cylinder is secured properly.
- Armbands in place.
- Staff Knowledge: Purpose and use of an Unusual Occurrence Report. What is a Confidential Report of Unusual Occurrence? And give an example of when one might be used in your area? Medical equipment malfunctions and failures, including one involving a patient injury. Medical equipment malfunctions and failures are reported immediately to Bio-Med A red out-of-service tag is completed and placed on the equipment. The equipment is removed from service until approved for re-use by Bio-Med. Incidents in which a patient is possibly or actually harmed; an Unusual Occurrence Report must also be completed and sent to Risk Management.
Comments:
Signature upon completion of Audit
Use this template