Lumiform Template Library

Health Services

5 Moments of Hand Hygiene - Infection Control

5 Moments of Hand Hygiene - Infection Control

Use this checklist template to check if employees know the 5 Momenet of hand hygiene.

Accident Incident Report Form

Accident Incident Report Form

Use this template to write a complete accident report.

Aged care facility resident handling assessment tool

Aged care facility resident handling assessment tool

Verifying Workplace Activity

Ambulance Equipment Requirement Checklist

Ambulance Equipment Requirement Checklist

Use this template to check equipment requirements in Ambulances

Anesthesia Infection Prevention Assessment Checklist

Anesthesia Infection Prevention Assessment Checklist

Use this template to check if guidelines for infection prevention and control in anesthesia practices are followed.

Annual Residential Care Home Inspection

Annual Residential Care Home Inspection

Annual inspection

Automatic fire alarm indident report

Automatic fire alarm indident report

Building number

BIR Fire Drill

BIR Fire Drill

To be completed immediately following all fire drill response activities.

Building Rounds

Building Rounds

monthly building inspection

Care Home Audit Maintenance and Domestic

Care Home Audit Maintenance and Domestic

Home Audit Template

Care Homes Health & Safety Audit

Care Homes Health & Safety Audit

Workplace H&S inspection report

CARF Inspection

CARF Inspection

Emergency Warning Devices

CMS-Emergency Management Survey Rounds

CMS-Emergency Management Survey Rounds

Regulatory

Communications Exercise Region L

Communications Exercise Region L

Southern link

Construction Safety Risk Assessment

Construction Safety Risk Assessment

Risk Assessment

Covid-19 | Hygiene Concept for Therapy, Wellness and Spa Facilities

Covid-19 | Hygiene Concept for Therapy, Wellness and Spa Facilities

COVID-19 | Preparation checklist for healthcare providers (CDC)

COVID-19 | Preparation checklist for healthcare providers (CDC)

This checklist is for service providers in the healthcare industry. It can be used to review steps in preparing for transport and upon arrival of patients with confirmed or possible COVID-19.

Covid-19 | Screening Checklist for Visitors and Employees

Covid-19 | Screening Checklist for Visitors and Employees

Use this checklist to screen visitors and staff of healthcare facilities for Covid-19 symptoms before they enter.

Covid-19 | Social Distancing Plan for Nursing Homes and Adult Care Facilities

Covid-19 | Social Distancing Plan for Nursing Homes and Adult Care Facilities

Use this template to create a social distancing plan for nursing homes and adult care facilities.

Defibrillator Monthly Check

Defibrillator Monthly Check

Use this template for the monthly inspection of the defibrillator.

Dental Medical History Form

Dental Medical History Form

Patients can use digital dental medical history forms at dental clinics while waiting to be attended by dentists. This can be used to include optional photos for dental records.

Disaster Drill

Disaster Drill

Dept Disaster Drill Evaluation Form

DNV Survey Readiness Tool for building tour

DNV Survey Readiness Tool for building tour

Audit Tool

Employee Fit Test

Employee Fit Test

Use this template for Employee Qualitative Fit Test

Environment of Care

Environment of Care

Self Assessment

Environment of Care Rounds

Environment of Care Rounds

Safety inspections of clinical and non clinical departments.

Environment Of Care Rounds

Environment Of Care Rounds

Healthcare

Environmental Rounds

Environmental Rounds

Environmental Rounds

Environmental Rounds

Environmental Rounds

Environment of Care Rounds

Environmental Rounds - clinical area

Environmental Rounds - clinical area

Environment of Care Rounds