Introduction:

Hospital-acquired infections (HAIs) are a major safety concern for both health care providers and patients.

The US Center for Disease Control and Prevention identifies that nearly 1.7 million hospitalized patients annually acquire healthcare-associated infections (HCAIs) while being treated for other health issues and that more than 98,000 patients (one in 17) die due to these. Several studies suggest that simple infection-control procedures such as cleaning hands with an alcohol-based hand rub can help prevent HCAIs and save lives, reduce morbidity, and minimize health care costs. - NCBI

Ultimately, it is up to the health care personnel involved in patient care and those responsible for surveillance to ensure that adequate measures are being taken to control and ideally prevent infections in the hospital.

The fundamental components of infection control in all healthcare facilities are:

  • Hand hygiene
  • Sterilization
  • Cleaning
  • Disinfection
  • Personal Protective Equipment (PPE)

All of the above are addressed in the checklist and applied to all areas of the facility including patient rooms, break rooms, and general areas throughout the building. 

If infectious waste is inadequately managed, harmful microorganisms can be transmitted by direct contact, in the air, or by a variety of vectors, putting the health of hospital personnel, and patients, at risk.

By running this checklist, you ensure that everything is being done to control and minimize the spread of infectious waste throughout your healthcare facility.

Let's get started.

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Enter basic details

Hand hygiene:

Ensure all sinks are well stocked

Start by inspecting all of the sinks in the unit to ensure they are well stocked with soap and paper towels. 

Ensure alcohol hand rubs are well stocked

Check all alcohol rub dispensers and make sure they are well stocked. 

If any are empty or near-empty, re-fill them immediately.

Confirm hand hygiene posters are present

Inspect rooms in the unit to ensure that hand hygiene posters are present and placed in the appropriate places. 

If any posters are damaged or missing, note it down in the section below.

Utility and storage:

Inspect the linen cart(s)

Inspec the linen cart(s) and verify that they are clean by completing the sub checklist below.

  • 1
    The cart is covered when not in use
  • 2
    The cart has a solid surface on the bottom shelf
  • 3
    The cart is well stocked with cleaning equipment
  • 4
    Equipment is well organized
  • 5
    The cart is stored in the appropriate room/location

Inspect sink storage areas

Make sure that sink storage areas are empty and clean.

Check trash cans are not overflowing

It is very important that trash cans in the unit do not overflow. This is an easy way for infectious bacteria to spread.

It is also easy to avoid, and so should be monitored carefully to make sure patients and hospital workers are not adding trash to a can that is in need of being emptied.

Check ceiling tiles are not stained, wet or damaged

Inspect the ceiling tiles in the unit to make sure none are stained, wet or damaged in any way. 

If you spot any tiles that are, note down the location in the section below so you can report it to the relevant personnel at the end of the inspection. 

Ensure floors are clean

Make sure the floor in the unit is clean.

If any part of the floor looks particularly dirty, make sure a cleaner sees to it as soon as possible. 

Ensure supplies are stored at least 6 inches above ground

All supplies should be stored at least 6 inches above the ground to avoid infections spreading from the floor.

For sterile supplies, items must be stored in a humidity-controlled environment, covered in plastic or in a cabinet with doors or in storage devices that do not allow dust to settle. They must be no more than 12 inches from the floor and no more than 18 inches from the ceiling.

Ensure air vents are clean

Check all of the air vents in the unit to make sure they are clean, 

Dust builds up quickly in air vents, so it's important that they are cleaned regularly to prevent significant levels of dust accumulation. 

Patient rooms:

Make sure all surfaces are clean

Inspect all of the patient rooms in the unit, firstly making sure that all surfaces are clean and orderly. 

If there are any rooms in which the surfaces are not clean, note them down in the section below and report to the relevant personnel so they can be cleaned as soon as possible. 

Ensure bathrooms are clean and stocked

Inspect each bathroom and make sure they are clean and well stocked with soap and paper towels. 

If you identify any bathrooms that do not look like they are meeting hygiene standards or require restocking, note down their location in the section below and report to the appropriate personnel as soon as possible. 

Ensure PPE's are available as needed

Each patient room must be equipped with the necessary personal protective equipment (PPE).

Typically, this would include:

  • Disposable gloves
  • Aprons
  • Long-sleeved gowns
  • Surgical masks
  • Eye goggles

If any patient rooms appear to be missing PPE, note down their location and report to the relevant personnel as soon as possible. 

Ensure all furniture is in good condition

Check that all furniture is in good condition.

If any furniture shows signs of damage or decay, it should be disposed of and replaced as soon as possible. 

Check high areas for dust accumulation

Inspect high areas in patient rooms to ensure that there is no dust being accumulated. 

Ensure all medical equipment is clean

Inspect all medical equipment in patient rooms to make sure they are clean.

If there is any sign of dust or dirt accumulation on any equipment, a cleaner should be dispatched to the room as soon as possible.

Patient shower rooms:

Ensure the room is clean and orderly

Check that the shower rooms are clean, orderly, and well-stocked with soap and any other appropriate cleaning products. 

Ensure ceiling tiles are in good condition

Inspect the ceiling tiles in each shower room to make sure they are in good condition. If there is any sign of significant staining, wetness, or damage, note down the room location in the section below and report back to the relevant personnel. 

Being that shower rooms are significantly damper environments than other rooms in the building, they are more likely to cause staining or damage to ceiling tiles. 

Isolation rooms:

Verify the appropriate signage is in place

When inspecting isolation rooms, the first thing to make sure of is that the appropriate signage is in place. 

There should be a sign on or right next to the door clearly stating that this is an isolated room and nobody without permission is allowed to enter

Signage should also mention that anyone currently ill cannot enter the room and those who do enter must wear the appropriate PPE prior to entering. 

Ensure trash and sharps are handled appropriately

Ideally, the room should be equipped with touch-free trash cans to minimize the risk of infectious bacteria spreading.

Ensure that used (i.e. dirty) bins remain inside the isolation rooms.

A puncture-proof container for sharps disposal should be present in the room and must never be more than 3/4 full. 

Ensure the trolley is equipped with all appropriate PPE

A trolley should be set up just outside the door of the isolation room, stocking PPE and linen supply. 

Complete the sub checklist below to ensure that all equipment is available.

It is incredibly important that the following items be kept on the trolley at all times so that PPE is always available for health-care workers. 

  • 1
    Gloves (reusable vinyl or rubber gloves for cleaning, and latex single-use gloves for clinical care)
  • 2
    Eye protection (visor or goggles)
  • 3
    Face shield
  • 4
    Particulate respirators (N95, FFP2, or equivalent)
  • 5
    Medical masks (surgical or procedure)
  • 6
    Long-sleeved gowns
  • 7
    Plastic aprons
  • 8
    Plain soap (liquid if possible)
  • 9
    Clean single-use towels
  • 10
    Sharps containers
  • 11
    Appropriate detergent for cleaning and disinfecting
  • 12
    Large plastic bags
  • 13
    Clinical waste bags
  • 14
    Linen bag
  • 15
    Collection container for used equipment

If there is any PPE missing, note it down in the section below and report back to the appropriate personnel as soon as possible so it can be addressed. 

Confirm patients wear proper attire during transportation

Ideally, patients placed in isolation should remain in their isolation rooms with the door closed.

However, some situations require that the patient be transported, in which case it is critical that they wear the appropriate attire to avoid the spread of infection. 

When patients are being transported to and from an isolated room, they should wear surgical masks that cover their mouth and nose.

Procedures for these patients should be scheduled at times when they can be performed rapidly and when waiting areas are less crowded.

Kitchens/break rooms:

Ensure floors and walls are clean

Moving on to the kitchen/break rooms, the first thing to do is to make sure that the floors and walls are clean. 

If there is any food, trash, or dirt present, see to it that it is cleaned as soon as possible. 

Ensure all surfaces are clean and clutter-free

Next thing is to scan all of the surfaces in the room and make sure that they are clean and orderly.

Ensure all kitchen appliances are clean

Ensure all kitchen appliances are clean. 

Typically, this will include the following:

  • 1
    Microwave oven
  • 2
    Regular oven
  • 3
    Toaster
  • 4
    Coffee maker
  • 5
    Cooker
  • 6
    Electric grill
  • 7
    Refrigerator

Check food is labeled appropriately and not expired

All food, particularly in the refrigerator, must be labeled properly and not expired. 

If any items are clearly out of date or look suspicious (of course, a foul smell is a sure sign) they should be disposed of immediately.

Confirm there is no evidence of pests present

Pests are one of the most significant threats to infection control in any building.

For hospitals, the importance of preventing any pests from breaching the walls is of course absolutely critical. 

While it is difficult to be totally sure that there are no pests present during an infection control inspection, there are a few things you can check that will give you a better idea if there are any nasty little animals running around your facility. 

These are the following:

  • 1
    Check plumbing for leaks or condensation
  • 2
    Check if any drains show signs of being clogged
  • 3
    Check there are no food items on the floor

General unit:

Confirm the area is free of dust and clutter

Now that all specific rooms have been carefully inspected, its time to focus your attention on the general unit.

First and foremost, ensure that the area is clean and clutter-free.

If there are any specific areas that do not appear to meet cleanliness standards, note them down in the section below and report the relevant personnel so they can be cleaned as soon as possible. 

Confirm unused patient equipment is stored appropriately

Any equipment that is not being used must be stored appropriately in a store.

Proper storage conditions are important to protect stock from deterioration and damage. The store should be:

  • 1
    Secure
  • 2
    Clean
  • 3
    Dry
  • 4
    Not too hot or cold
  • 5
    Well ventilated
  • 6
    Free from pests
  • 7
    Not exposed to direct sunlight

Ensure clean/dirty linen is handled appropriately

Verify that clean and dirty linen is handled appropriately by hospital staff. 

Clean linen should either be stored in a clean, dry room or neatly placed on trolleys in the case that it will be used at some point during that particular day. 

Dirty linen should be placed in a linen waste bag on a trolley and taken to be washed as soon as the bag is near full.

Linen that is contaminated with blood or other bodily fluids should be handled by staff wearing Personal Protective Equipment (PPE) and is put into a red plastic bag labeled “Biohazard”.

Confirm infectious waste is in a red bag or container

All infectious waste must be placed inside a red bag or container labeled "Biohazard, Infectious Waste". 

Examples of infectious waste include:

  • Discarded blood
  • Sharps
  • Human or animal tissue
  • Used bandages and dressings
  • Discarded gloves

Confirm nothing is stored under sinks

Check to make sure that nothing is stored under any sinks. 

This is an important measure to prevent risk of infection because anything stored underneath a sink may be contaminated from soiled water that leaks from the sink drain. 

Confirm restrooms are clean

Check all of the restrooms in the unit/hospital and confirm that they are clean. 

If any restrooms appear to be in need of cleaning, note down their location in the section below and report to the relevant personnel as soon as possible. 

Employee knowledge:

Verify staff know the procedure for blood exposure

All health services must develop their own infection control protocols for communicable diseases. This includes clear written instructions on the appropriate action to take in the event of an exposure to blood or body fluids/substances, such as needlestick injuries and other blood or body fluid incidents involving either patients or healthcare workers. - health.vic

Ensure that staff are familiar with the protocol developed by your establishment.

Generally, treatment protocols should include the removal of contaminated clothing and thorough washing of the injured area with soap and water. Affected mucous membranes should be flushed with large amounts of water and eyes should be flushed gently.

Ensure personnel can locate the Infection Control Manual

All personnel should know where to locate an Infection Control Manual containing instructions and practices for patient care. 

The manual should be developed and updated by the infection control team and reviewed and approved by the committee.

Ensure personnel can locate the Exposure Control Plan

Any staff member can request to review the Exposure Control Plan (ECP) at any time during their work shifts.

Make sure that staff are aware of this ability and exercise it in the case that they cannot clearly recall the contents of the plan. 

You are required by the Occupational Safety and Health Administration (OSHA) bloodborne pathogens standard to develop an Exposure Control Plan.

Ensure personnel can locate the biohazard spill kit

All relevant personnel must know where to locate a biohazard spill kit in the case that they quickly need to manage spills and accidents involving biohazardous materials.

Check staff can state WHO's 5 moments of hand hygiene

Check to make sure that all staff can state the 5 moments of hand hygiene as stated by the World Health Organization (WHO).

Each of the 5 moments are displayed in the image below.

Also, there is a WHO hand hygiene leaflet attached and ready for download if you would like to do so.

Final step:

Summarize the infection control audit

Provide a brief summary of the infection control audit so that it can be reviewed and approved by a senior staff member. 

Leave any additional comments

If there is anything you identified during the infection control process that you think needs to be addressed or if you would like to provide a quick summary of the inspection, do so in the section below.

Approval: Confirm the infection control audit has been completed

Will be submitted for approval:
  • Summarize the infection control audit
    Will be submitted

Sources:

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