Lumiform / Templates / Hospital Housekeeping Checklist Template

Hospital Housekeeping Checklist Template

Keeping the hospital clean and sanitized between patients can help cut back on hospital-acquired infections. This includes the management and disposal of human and biological waste. Use this hospital housekeeping checklist to easily specify the unit and room to be cleaned. In addition, you can:

• Check isolation status
• Perform hand hygiene
• Check for appropriate PPE
• Take/attach photos of cleaned patient rooms
• Add annotations of high-trafficked areas & surfaces
• Complete the hospital housekeeping checklist with a digital signature
• Automatically generate and share the hospital housekeeping report before leaving the room.

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Hospital Housekeeping Checklist Template

Hospital Housekeeping Checklist

Unit

Room Number

Before entering room

Check isolation status

Perform hand hygiene

Don appropriate PPE

Place wet floor sign in front of the door

Check the sharps container (change if necessary)

Empty and clean the trash container (handle plastic bags from the top)

Patient bed

Raise and wipe down arm rails – high touch area

Wipe foot of bed

Discard the rag and proceed with a clean one after cleaning the bed

Move clockwise from the door and sanitize all equipment

Ledges (below shoulder height)

Door handles, knobs – high touch surfaces

Light switches – high touch surfaces

Call box – high touch surfaces

Telephone – high touch surfaces

Computer keyboard – high touch surfaces

Window sills and ledges

Soiled linen hamper lid

In-room patient sink and faucet

In-room soap dispenser and paper rag dispenser

Biohazard can

Dry erase marker

Overbed table – high touch surfaces

Patient chairs – high touch surfaces

Bedside tables – high touch surfaces

All other easily accessible wall mounted equipment

Clean commode frame and seat cover last

Patient restroom

Clean mirror with glass cleaner and wipe dry with a paper towel

Light switches – high touch surfaces

Door handles, knobs – high touch surfaces

Hand rails – high touch surfaces

Sink and sink counter – high touch surfaces

Clean soap and paper towel dispensers

Wipe shower or tub

Spot walls

Clean commode frame and seat cover

Change rags before cleaning the toilet

Toilet

Toilet paper dispenser

Toilet flusher – high touch area

Toilet seat – high touch area

Under the bowl

Toilet rim

Clean inside of bowl with disinfectant cleaner and toilet brush

Before leaving room

Remove gloves and perform hand hygiene

Restock supplies

Mop floor

Perform hand hygiene

Remove wet floor sign after the floor has dried

Completion

Additional Comments

Hospital Housekeeper Name & Signature

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Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.