Autoclaves: chemical and biological indicators are used appropriately YES NO Biological indicators run at least weekly or with each load with an YES NO implantable Sterilization logs accurate and up to date YES NO Process is in place for embargo of instruments until BI is read YES NO Sterile packages are inspected for integrity and compromised packages YES NO are reprocessed XI. General Decontamination/HLD/Sterilization Proper PPE is worn when processing equipment YES NO Competencies are maintained for cleaning, disinfection and sterilization YES NO processes HLD, decontamination, and /or sterilization is performed in appropriate YES NO environment Areas used for cleaning or disinfection flow from dirty to clean YES NO is a procedure in place for identification and recall of inadequately YES NO sterilized or high level disinfected instruments After sterilization or high level disinfection, devices and instruments are stored in a designated clean area so sterility/cleanliness is not YES NO compromised XII. Isolation Staff are able to articulate isolation policies (such as for TB, chickenpox, YES NO Etiquette”) “Respiratory Staff are able to state how patients should be managed that have a known resistant organism (e.g. MRSA, VRE, C. difficile, draining wound or YES NO rash) Personal protective equipment (PPE) is available YES NO XIII. General Issues Areas free of dust, dirt, soil, trash, odors, clutter and hazards (fixtures, YES NO walls, ceilings, floors) and furnishings are in good repair YES NO Objects and environmental surfaces that are touched frequently in patient care areas (stretchers, IV pumps and poles, medication prep areas, YES NO procedure tables, toilet surfaces, waiting area surfaces) are disinfected with an EPA-registered, ASC designated and approved disinfectant. Environmental cleaning contracts follow ASC Infection Control Policy YES NO
Autoclaves: chemical and biological indicators are used appropriately YES NO Biological indicators run at least weekly or with each load with an implantable YES NO Sterilization logs accurate and up to date YES NO Process is in place for embargo of instruments until BI is read YES NO Sterile packages are inspected for integrity and compromised packages are reprocessed YES NO XI. General Decontamination/HLD/Sterilization Proper PPE is worn when processing equipment YES NO Competencies are maintained for cleaning, disinfection and sterilization processes YES NO HLD, decontamination, and /or sterilization is performed in appropriate environment YES NO Areas used for cleaning or disinfection flow from dirty to clean YES NO is a procedure in place for identification and recall of inadequately sterilized or high level disinfected instruments YES NO After sterilization or high level disinfection, devices and instruments are stored in a designated clean area so sterility/cleanliness is not compromised YES NO XII. Isolation Staff are able to articulate isolation policies (such as for TB, chickenpox, “Respiratory Etiquette”) YES NO Staff are able to state how patients should be managed that have a known resistant organism (e.g. MRSA, VRE, C. difficile, draining wound or rash) YES NO Personal protective equipment (PPE) is available YES NO XIII. General Issues Areas free of dust, dirt, soil, trash, odors, clutter and hazards (fixtures, walls, ceilings, floors) YES NO and furnishings are in good repair YES NO Objects and environmental surfaces that are touched frequently in patient care areas (stretchers, IV pumps and poles, medication prep areas, procedure tables, toilet surfaces, waiting area surfaces) are disinfected with an EPA-registered, ASC designated and approved disinfectant. YES NO Environmental cleaning contracts follow ASC Infection Control Policy YES NO
1.01_ASC_Environmental_Rounds_Survey_Tool_1.docx