Environment of Care Compliance

Which department are you completing this survey for?

Medication prep area is clean and free of clutter.

Pease comment on findings.

No supplies are stored within splash zone (3 feet) of hand-washing sink.

Please comment on finding(s).

Water bottles labeled with beyond use date and time.

Water bottles expire 24 hours after opening.

What element was missing?

Single patient use pill cutters are labeled with patient information and stored in a baggie.

What element was missing?

Computers/laptops are clean and away from medication prep area.

Paperback drug reference books are clean/current.

What was found?

Oxivir wipes are available for cleaning surfaces before medication preparation.

All medications are labeled (Multi dose medications, MDV’s - labeled (28-day max expiration with initials).

Please comment on findings.

Controlled substances are secured in a locked ADC (Omnicell) bin or Flex-Locked refrigerator.

Please comment on finding(s).

Chemo spill kits are available (if applicable) with no expired supplies.

Please comment on any findings.

What is the medication room number?