QUALITY OF CARE ROUNDS - Nursing Home Help
QUALITY OF CARE ROUNDS - Nursing Home Help QUALITY OF CARE ROUNDS - Nursing Home Help
INFECTION CONTROL AND SAFETY SURVEILLANCE:Responsible Person:Date:ACTIVITIES / SOCIAL SERVICESYes No All work areas are cleaned and disinfected after each resident’s use.Yes No All reusable equipment/supplies are cleaned and disinfected after resident’s use.Yes No Area is clean and free of peeling paint, chips, cracked furniture or equipment.Yes No Activities/Social Services employees are in-serviced annually and understand and followStandard Precautions/Infection Control.Yes No Volunteers have been in-serviced on prevention and potential sources of infection.Yes No Chemicals are properly labeled and stored in a closed, locked area.Yes No Activities/Social Services employees can locate blood spill kit and verbalizecorrect usage of kit.Yes No Gloves and/or gowns are used appropriately.Yes No MSDS & Safety Manuals are available in each department.Yes No Floors do not have any slip, trip or fall hazards.Yes No Activity employees are trained in use of fire extinguishers.Corrective action and/or follow-up required:4.43
INFECTION CONTROL AND SAFETY SURVEILLANCE:Responsible Person:BEAUTICIAN / BARBER SERVICESDate:Yes No All work areas are cleaned and disinfected after each resident’s use.Yes No Service area is clean and free of peeling paint, chips, and cracked equipment.YesNoAll reusable equipment (brushes, combs, clips, curlers) are cleaned and disinfected aftereach resident’s use.Yes No Capes and towels are cleaned and stored in a cupboard when not in use.Yes No Sink is cleaned and disinfected after each resident’s use.Yes No Hair is removed from the floor after each resident’s haircut.Yes No Chemicals are properly labeled and stored in a closed locked area.Yes No Proper hand washing is performed after each procedure.YesNoBeautician and barber are in-serviced annually and understand and follow StandardPrecautions/ Infection Control.Yes No Beautician and barber can locate blood spill kit and verbalize correct usage of kit.Yes No Gloves and/or gowns are used appropriately.Yes No MSDS & Safety Manuals are available in each department.Yes No Floors do not have any slip, trip or fall hazards.Corrective action and/or follow-up required:4.44
- Page 1 and 2: Quality ofCare RoundsUnlike the Moc
- Page 4 and 5: RR SS PE IC EP F-Tag Observations S
- Page 6 and 7: RR SS PE IC EP F-Tag Observations S
- Page 8 and 9: RR SS PE IC EP F-Tag Observations S
- Page 10 and 11: RR SS PE IC EP F-Tag Observations S
- Page 12 and 13: Exit lightsRESIDENT ROOMS “U”
- Page 14 and 15: OTHER AREAS “U” “S” COMMENT
- Page 16 and 17: Thawing foods put in refrigerator c
- Page 18 and 19: SS follows upon discharge needs of
- Page 20 and 21: - re-feeding/walk and dine- bowel/b
- Page 22 and 23: Pumps/poles and equipment cleanWEIG
- Page 24 and 25: No expired medications on handSharp
- Page 26 and 27: Medical Director review of all repo
- Page 28 and 29: MDS/CARE PLAN TRACKING FORMName: Ro
- Page 30 and 31: HOT HOLDINGHot holding unit / steam
- Page 32 and 33: Step ladders are sturdy and in good
- Page 34 and 35: Yes No Buckets, tubs and pans are i
- Page 36 and 37: Yes No Cleaning schedules posted an
- Page 38 and 39: INFECTION CONTROL AND SAFETY SURVEI
- Page 40 and 41: Yes No Electric cords for lights, r
- Page 42 and 43: INFECTION CONTROL AND SAFETY SURVEI
- Page 46 and 47: INFECTION CONTROL AND SAFETY SURVEI
- Page 48 and 49: INFECTION CONTROL AND SAFETY SURVEI
- Page 50 and 51: INFECTION CONTROL AND SAFETY SURVEI
- Page 52 and 53: Yes No All wandering bracelets are
- Page 54 and 55: Extended menusavailableDumpster lid
- Page 56 and 57: Housekeeping Carts, Equipment, and
- Page 58 and 59: Facility InspectionFacility _______
- Page 60 and 61: Facility Inspection ReportPossibleA
- Page 62 and 63: Facility Inspection ReportAREAScore
- Page 64 and 65: Figure A.7Survey tag assignment (co
- Page 66 and 67: Figure A.7Survey tag assignment (co
- Page 68 and 69: Figure A.7Survey tag assignment (co
- Page 70 and 71: Figure A.7Survey tag assignment (co
- Page 72: Figure A.7Survey tag assignment (co
INFECTION CONTROL AND SAFETY SURVEILLANCE:Responsible Person:Date:ACTIVITIES / SOCIAL SERVICESYes No All work areas are cleaned and disinfected after each resident’s use.Yes No All reusable equipment/supplies are cleaned and disinfected after resident’s use.Yes No Area is clean and free of peeling paint, chips, cracked furniture or equipment.Yes No Activities/Social Services employees are in-serviced annually and understand and followStandard Precautions/Infection Control.Yes No Volunteers have been in-serviced on prevention and potential sources of infection.Yes No Chemicals are properly labeled and stored in a closed, locked area.Yes No Activities/Social Services employees can locate blood spill kit and verbalizecorrect usage of kit.Yes No Gloves and/or gowns are used appropriately.Yes No MSDS & Safety Manuals are available in each department.Yes No Floors do not have any slip, trip or fall hazards.Yes No Activity employees are trained in use of fire extinguishers.Corrective action and/or follow-up required:4.43
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