close
lumiform
Lumiform Mobile audits & inspections
Get App Get App

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.

Downloaded 185 times

Rated 5/5 stars on Capterra

Say goodbye to paper checklists!

Lumiform enables you to conduct digital inspections via app easier than ever before
  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 5,000 expert-proofed templates

Digitalize this paper form now

Register for free on lumiformapp.com and conduct inspections via our mobile app

  • Cut inspection time by 50%
  • Uncover more issues and solve them 4x faster
  • Select from over 4000 expert-proofed templates
Rated 5/5 stars on Capterra

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
Share this template:
This template is also available in: