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Natchitoches Regional Medical Center

Departmental Safety Rounds - Clinical

Purpose: To conduct monthly environmental tours of all clinical areas of the organization to determine whether the current activities used to manage the Environment of Care are effective, and to identify and correct hazards which may exist to patients, staff or visitors.
Please only select one choice per question.
Associated Event   
* Department Responding
* Handrails are attached firmly to the wall Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* All wheelchairs have both footrest Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* All wheelchairs are in good repair Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Storage is at least 18 inches or more from ceiling Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Storage is at least 6 from the floor Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* No boxes stored on the floor Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Ceilings-tiles, intact, clean, no water stains Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Floors-tiles, carpet in good repair Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Utility room clean and orderly Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Electrical outlets are not damaged or loose Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Oxygen tanks are stored properly-none lying on the foor or standing unsecured Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* No items are being stored under the sinks Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Desk, chairs, Furniture in safe condition-not wobbly or torn fabric Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Patient room furniture in safe condition no tears, or broken items Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Critical equipment is plugged into Red Outlets Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Linen are covered and linen cart has solid bottom Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Eye wash station inspected weekly and documented Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* No fall or trip hazards identified (cords, frayed carpet, etc) Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* No door wedges or door stops found Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Fire Alarm Pull boxes and fire extinguisher are not blocked Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Exit lighting visible, lit and not damaged Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Hallways are clear. Equipment temporarily stored in halls must be mobile and on one side. Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* No paper signs are posted on doors o walls (except infection control materials supplied by NRMC) Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* All doors latch properly Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* No unauthorized space heaters found in office or patient sleep areas Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Crash Cart daily check list has been completed with no gaps Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* No vials or syringes are left out or in unsecured drawers or cabinets Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Patient food refrigerator/freezer clean and documented with no gaps Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Refrigerator temperatures documented with no gaps and action plan Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* All reagents are dated when opened (Point of Care Testing) Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Employee personal items are secured out of sight Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* No evidence of food, drinks or eating occurring in nurse station Yes     No - Work Order Submitted/Deficiency Corrected     NA    
* Sharps boxes are no more than full; syringe disposed of properly Yes     No - Work Order Submitted/Deficiency Corrected     NA    
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