You are on page 1of 2

/QUA/HIC/SC/23

S. SURVEILLANCE CHECK LIST


No

Date
Waste management
To ensures proper segregation of the waste(no
1
mixing)

2 No overfilled waste bags in use

Staff know about segregation of waste according to


3
BMW Rules 2016
Waste bins are covered & visibly clean with
4
disinfectant solution

Waste bags are tied securely and labelled before


5
sending to bio-medical waste storage area
Waste transport is in coverd trolley & using proper
6 PPE

General Environment

Daily cleaning procedures for surface, furniture and


7
patient surrounding area

8 Blood and body fluid spill cleaning & management

Opening date mentioned on multi doses medicine


9
vials & syrups
Insertion date on peripheral/central lines, drip set
10
present
No unwanted items like cap, mask are mixed in
11
laundary bag

Hand Hygiene

Display for necessary instructions on display


12
available near hand washing area
Optimal Hand hygiene maintained by all in patient
13
care unit
14 Staffs follow WHO hand washing moments

Staffs know about seven step of hand


15
washing(Observe/ask)

Sterilization Practices

Used and sterile items kept store seperately with


16
label in unit
Sterile item storage area free from dust and cleaned
17
daily

Others

18 Spot training as required

19 Patient bed linen changed daily

20 Dirty linen stored at designated area

21 Slippers according to zone


22 Any other observation while surveillance

SIGNATURE (Incharge/ Staff in that department)

Observed by ………………………………… Signature ……………………….. Date…………………………………..

Action Taken :

You might also like