Hospital housekeeping checklist
Use this hospital housekeeping checklist to easily specify the unit and room to be cleaned, check isolation status, perform hand hygiene, check for appropriate ppe, and more, take::Attach photos of cleaned patient rooms and add annotations of high-touch surfaces, complete the hospital housekeeping checklist with a digital signature, and automatically generate and share a hospital housekeeping report before leaving the room.
What does this form include?
This form contains 9 sections:
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Before entering room
- Check isolation status
- Perform hand hygiene
- Don appropriate PPE
- Place wet floor sign in front of the door
- Check the sharps container (change if necessary)
- Empty and clean the trash container (handle plastic bags from the top)
Patient bed
- Raise and wipe down arm rails – high touch area
- Wipe foot of bed
- Discard the rag and proceed with a clean one after cleaning the bed
Move clockwise from the door and sanitize all equipment
- Ledges (below shoulder height)
- Door handles, knobs – high touch surfaces
- Light switches – high touch surfaces
- Call box – high touch surfaces
- Telephone – high touch surfaces
- Computer keyboard – high touch surfaces
- Window sills and ledges
- Soiled linen hamper lid
- In-room patient sink and faucet
- In-room soap dispenser and paper rag dispenser
- Biohazard can
- Dry erase marker
- Overbed table – high touch surfaces
- Patient chairs – high touch surfaces
- Bedside tables – high touch surfaces
- All other easily accessible wall mounted equipment
Patient restroom
- Clean mirror with glass cleaner and wipe dry with a paper towel
Toilet
- Toilet paper dispenser
- Toilet flusher – high touch area
- Toilet seat – high touch area
- Under the bowl
- Toilet rim
Before leaving room
- Remove gloves and perform hand hygiene
- Restock supplies
- Mop floor
- Perform hand hygiene
- Remove wet floor sign after the floor has dried
Additional Comments
Hospital Housekeeper Name & Signature
Use this template