General infection control audit checklist
Use this infection control audit template to ensure the completion of baseline control measures against healthcare-associated infections.
What does this form include?
This form contains 15 sections:
Employees Monitored
Hand Hygiene
- Sinks for hand hygiene are well stocked?
- Sinks are available in all areas as needed?
- Alcohol hand rubs are well stocked?
- Alcohol hand rubs are available in patient's rooms?
- Placement of alcohol hand rubs is compliant with safety?
- Hand washing/hand hygiene is performed between patients?
- Hand Hygiene reminder posters present?
- Hand soap is available in all hand washing stations/bathrooms?
Clean Utility / Central Supply / Storage
- Clean linen cart is covered?
- Clean linen cart has solid surface on bottom shelf?
- Sink storage area empty and clean?
- Thrash cans or waste basket are not overfilled or overflowing?
- Ceiling tiles are not stained or wet?
- Floors are clean?
- Supplies are stored at least 6 inches off of the floor?
- Air intake vents and diffusers are clean?
- Is this section free of additional findings?
Patient Rooms
- Horizontal surfaces are clean?
- Thrash cans or waste basket are not overfilled or overflowing?
- Bathrooms are clean?
- Hand hygiene products are available?
- Soap and paper towels are available in each bathroom?
- PPE's are available as needed?
- Patient equipment is clean?
- No visible soil on vertical surfaces?
- Ceiling tiles are not discolored, wet, missing, or damaged?
- Air intake vents and diffusers are clean?
- Furniture (chairs, sleepers) are without tears or wear?
- Mattress pad is without tears or puncture holes?
- Floors are clean?
- Sharp containers are no more than 3/4 full?
- Dust not found in high places?
- General area is dust free?
REFERENCE: General area is dust free[This is an example of how you can use iAuditor to include best p
Patient Kitchen / Breakroom
- Floors and walls clean?
- Horizontal and vertical surfaces are clean?
- Microwave oven clean?
- Refrigerator clean and thawed of ice?
- Under sink clean and without storage?
- Patient refrigerator labeled for patient use only?
- Temperature checks are documented with corrective action when temp is out of range?
- Patient food is labeled appropriately with no expired food found?
- Ice machine is clean?
- There is no evidence of pest present?
- Is this section free of additional findings?
Employee Kitchen / Breakroom
- Floors and walls clean?
- Horizontal and vertical surfaces are clean?
- Microwave oven clean?
- Refrigerator clean and thawed of ice?
- Under sink clean and without storage?
- Employee food labeled and dated?
- Temperature checks are documented with corrective action when temp is out of range?
- Is this section free of additional findings?
General Unit / Nurses Station / Medication Room
- Unit/area generally clean (without dust, clutter or debris)?
- Unused patient equipment/supplies are stored and handled appropriately?
- Medication, specimens, and food are handled appropriately?
- Biohazard trash is segregated from regular trash?
- Clean linen is handled appropriately?
- Dirty linen is handled appropriately?
- All clean linen carts are covered?
- Linen carts have a solid bottom shelf?
- Needles and syringes are disposed of properly?
- Out of date supplies are not present?
- Infectious waste in red bag or container?
- Clean items are not stored in soiled utility room?
- Ceiling tiles are not discolored/ wet/ missing / damaged?
- Lab supplies are not expired?
- Nothing is stored under the sink and there is no sign of leaks?
- Halls are uncluttered?
- Respiratory hygiene available?
- Restrooms clean?
- Trash basket are not overflowing?
- Biohazard symbol on door of biomedical waste storage?
- Medication cart locked?
- No artificial/acrylic nails use. Nails are no more than 1/4 inch above finger?
- No personal lotion use.
- Medication Room refrigerator is clean and without ice?
- There are no expired products found(IV solutions, medications, reagents, nutritional supplement, sterile items, etc.)
- Is this section free of additional findings?
Logs
- Crash cart checked daily?
- Defibrillator checked daily
- Narcotic counts documented every shift?
- Temperature checked BID for vaccine / medication storage?
- Daily refrigerators checks with corrective actions as needed?
- Ice machine cleaning date / time stamped?
- Glucose meter strips dated
- Cidex monitoring Log complete?
- Is this section free of additional findings.
Isolation Rooms
- Appropriate signage in place?
- Supplies and PPE's available?
- Trash and linen handled per policy?
- Appropriate PPE's used by staff?
- Door closed as appropriate?
- Negative pressure is being supplied as required?
- Patient and family instructed on isolation requirements?
- Patient with proper attire when being transported?
- Is this section free of additional findings?
Employee General Knowledge
- Employees know the procedure for blood exposure?
- Personnel can locate their Infection Control Manual?
- Personnel can locate their Exposure Control Plan?
- Personnel can locate the blood spill kit?
- Personnel can locate their spill kit for Cidex?
- Employees can state the WHO's 5 moments of Hand Hygiene.
- Dust not found in high places?
- Is this section free of additional findings?
Soiled Linen / Dirty Utility Room
- Biohazard symbol on door of biomedical waste storage?
- Boxes are stored at least 6 inches off of the floor?
- Walls / floors are clean
- Ceiling tiles are not discolored/ wet/ missing / damaged?
- Dust not found in high places?
- Is this section free of additional findings?
Patient Shower Room
- Shower clean?
- Shower room clean and orderly?
- Walls and floor are clean?
- Ceiling tiles are not discolored/ wet/ missing / damaged?
- Dust not found in high places?
- Is this section free of additional findings?
Additional Comments
Surveyor's Name and Signature
Use this template