Facilities/Advanced Patient Care
Layout and potential use of former advanced care areas for general surge. Aspects being evaluated for general surge capacity, not for original purposes.
Date: ____________ Location: _______________________ Team member: __________________________
Operating Rooms
Observations:
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|
General Condition:
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Description of Structural Components
| Floors: | |
| Ceilings: | |
| Windows: | |
| Doors: | |
| Missing, Damaged Structural Components (Note Location): |
Pests/Mold
Description and location:
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Communications
| Nurse call system? | |
| Other? | |
| Telemetry system? |
Lighting
| Regular: | |
| Emergency: |
HVAC and Air Flow (ducts, vents, and radiators)
| General condition: |
Air Flow:
| Y | N | Sinks? |
| Y | N | Floor drains? |
Fire Suppression:
| Y | N | Sprinkler heads? |
| Y | N | Extinguishers? |
Waste Management and Hazardous Materials:
| Y | N | Containment and storage capability? |
| Y | N | On-site treatment/management set-ups? |
Hazardous Materials Management (storage, use):
| Y | N | Segregated hazardous wastes storage? |
| Y | N | Shielded radioactives storage? |
| Y | N | Eye washes, drench showers? |
| Y | N | Flammables cabinets? |
| Y | N | Compressed gases chains? |
