RESPIRATORY CARE ENVIRONMENTAL/ BEHAVIORAL ROUNDS TOOL

Date:_ ________ Unit/Dept:__________________ _ Patient information of any type (screens, patient lists, white boards, clipboards, handoff or rounds areas) is secured and HIPAA compliant Difficult Airway Carts Checked Code Carts checked, Code bag contents working and in date (ISTAT cartridges, ETCO2), logs signed Storage/tank room is neat, well organized and locked Medications secured, labeled for patient use
All oxygen cylinders are secured in a rack or therapy apparatus and marked so that staff can distinguish between full and empty;

Performance acceptable

Needs improvement

Comments

Hallways are clear and uncluttered (Walkway requirement is 8 ft. unless the equipment is in use); Equipment storage meets standard No food or drink in equipment or patient care areas, ID badge displayed, personal items stored in lockers Articulates safety improvement work Interdisciplinary Rounds/care plans Medical Record Documentation Demonstrates knowledge of fire plan in all clinical and non-clinical areas (locates pulls, shutoffs, fire compartments and fire doors) Demonstrates infection control standards (hand hygiene, PPE, disposal of waste, VAP) Demonstrates completion of safety checks (trauma room readiness, emergency equipment, standby equipment, portable O2, trach boards, travel bags)
Comments/Issues:

Staff performing rounds: