LABOUR ROOM AUDIT CHECK LIST

S.No DISPLAY Status Responsibility Target Date Remarks

1 5 moments of Hand Hygiene Not Available
2 Hand wash Not Available
3 Hand rub Not Available
4 Needle stick Injury Protocol Not Available
5 Blood and Body fluids spill protocol Not Available
6 Mercury spill protocol display Not Available
7 Biomedical waste management display Available
8 Asset Label Not Available
9 PM Label Not Available
10 Calibration Label Not Available
Instruction /operator protocol displayed in the Machine
11 Not Available

12 Emergency codes Not Available

13 Material Safety Data Sheets Display Not Available
14 Hazardous materials cupboard Not Available
15 Medication Cupboard Not Available
16 Active Managment of Third stage of labour Not Available
17 Labour room protocol Not Available
18 Partograph Not Available
19 Essential Newborn care Not Available
20 MTP License
21 HIRA Not Available
22 MEWS score for OBG Not Available
23 LASA and high alert medication display Not Available
24 Fire Exit Not Available
25 Materials Holding area signages Not Available
26 Departmental signages Available
27 Labour Room Available
28 Entry Restricted Not Available
29 Please remove your footwear here Available
30 Fridge medications Not Available
31 Escalation Matrix Not Available
32 Complaint contact number-Labour Waiting area Not Available
33 Fire exit Not Available
34 Department organogram display Not Available
IMPLEMENTATION
Safety of electrical plugs & Sockets-(Check for loosely
1 tangling wires)
Any damaged items in the area which has potential for
2 Injury.
3 Separate Slippers for wearing Available
4 Cap and mask availability Available
5 Availability of hand rub at the entrance Available
6 Availability of Hand rub inside the Labour room Available
7 Availability of hand wash solution Not Available
8 Availability of PPE for Pregnant woman Not Available
 Segregation of sound alike, look alike and high alert
9 medications Not Available

10 Red dot in high alert medication ampoules Not Available

11 Mobile oxygen cylinder Available
12 Suction Apparattus Status
13 Crash Cart Available
14 Ward Inventory Not Available
15 Elbow or Knee action tap Not Available
16 Availability of sterile labour trays Available
17 Spill kit for Blood and body fluids Not Available
18 Spill kit for Mercury Not Available
19 Stretcher with safety belts Not Available
20 Wheel chair with safety belts Not Available
21 Linen trolley-Clean linen and Soiled linen separately Not Available
22 Needle cutter Not Available
23 Puncture proof container Available
24 Availability of Biomedical waste bins Available
25 High level disinfectants Not Available
26 Employee health check up Available
27 Staff vaccination Available
28 Medication label Not Available
29 Eye Wash Not Available
30 Grab bars in patient rest rooms Not Available
31 Adequate side rails Not Available
32 CCTV surveillance Available
33 Hazardous materials are identified and stored Not Available
separately under lock and key
34 UPS for warmer, light and fan Available
35 Newborn care Area Available
DOCUMENTATION
1 Labour room Nominal register Available
2 Birth Register Not Available
3 MTP Register Not Available
4 Stillbirth register Not Available
5 Maternal death register Not Available
6 Contraceptive insertion register Not Available
7 Labour room assessment form Not Available
8 Medication stock register Available
9 WHO safe childbirth checklist Not Available
10 Narcotic stock Register Not Available
11 Transfer Register Not Available
12 Consent for procedures Not Available

13 Vulnerable assessment form-High risk obstetrics cases Not Available

14 MTP Consent Not Available

15 Consent for IUCD insertion Not Available
16 Departmental Manual Not Available
17 Equipment Stock Register Not Available
18 HPE register Not Available
19 Communication Register Not Available
20 CSSD register Not Available
21 Indent register Not Available
22 Equipment Breakdown register Available
23 Equipment operating manual Not Available
24 Asset list of equipments Not Available
25 Preventive Maintenance plan Not Available
26 Complaint Register Not Available
27 Referral form Not Available
28 LAMA form Not Available
29 Transfer order form Not Available
30 CPR Register Not Available
31 Deep cleaning Record Not Available
List of sound alike, look alike and high alert medications
32 list Not Available

33 Emergency trolley medicine checklist Not Available

34 O2 Cylinder checklist Available
35 Suction apparattus checklist Available
36 Code blue report form Not Available
37 Medication error report form Not Available
38 Adverse drug event reporting form Not Available
39 Emergency drill reporting form Not Available
40 CSSD Recall Register Not Available
41 Medication Recall Register Not Available
42 Incident Reporting form Not Available
43 Safety checklist for procedures Not Available
44 Procedure form Not Available
45 Blood transfusion register Not Available
46 Blood request form Not Available
47 Blood transfusion monitoring chart Not Available
48 Post transfusion reaction reporting form Not Available
49 Needle stick injury reporting form-General Not Available
50 Post exposure reporting form-General Not Available
51 Hospital Formulary Not Available
52 Swab culture report Not Available
53 MSDS file Not Available
54 Antibiotic policy Not Available
55 Housekeeping cleaning checklist Available
56 Biomedical waste collection checklist Available
57 Adequate staff available as per INC ratio
58 Handing Over Register Not Available
59 Duty Roster Available
TRAINING
1 Departmental SOP & Policies
2 Emergency codes
3 Patients rights & Responsibilities
4 Employee rights & responsibilities
5 Occupational Hazards
6 Incident Reporting system
7 Hospital Vision, Mission & Values
8 HIC Practices
9 MEWS
10 BLS, ACLS
11 Patient Safety goals
12 Narcotic Policy
13 NABH OT Guidelines
14 HEPA Filter checking record
15 Radiation safety training
16 Sample collection training
17 Recall procedure
18 Fire safety