Template

OR WalkRound Internal Audit Checklist

by NQMA KFMC, from the Community

10+

Audit your operating room against best-practice standards with this OR WalkRound internal audit checklist. It covers leadership and staffing requirements, nurse manager qualifications and competency assessments, preoperative evaluation and documentation, patient acceptance and surgical counts, day surgery policies, operative reporting, postoperative care plans, and pain management. Fire safety, environmental controls, and comprehensive infection prevention and control measures are included to help teams improve safety, compliance, and quality of surgical services.

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Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

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Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Operating Room Internal Audit Checklist
Use this Operating Room internal audit checklist to evaluate compliance across surgical services. Review leadership qualifications, nurse management, staff competencies, pre-operative assessment, and consent. Verify OR policies on patient identification, infection prevention, equipment checks, environmental controls, and safe handling of specimens, chemicals, and blood. Assess processes to prevent retained items, day surgery criteria, operative reporting, pathology requirements, post-operative care, pain management, fire safety, and air-handling standards.
by Louise Nortje, from the Community
Downloads: 10+
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Template
UM WalkRound Cross Audit - Day Surgery
This day surgery WalkRound cross audit template helps hospitals and surgical centers evaluate compliance with key policies and procedures for same‑day surgical care. It covers defining eligible day surgery procedures and non-candidate criteria, processes for unplanned admissions from the day surgery unit, physician discharge orders, escort requirements, and patient or family education with follow-up instructions. Use it to strengthen patient safety, standardize workflows, and improve perioperative quality.
by Cherry Rose Bornea, from the Community
Downloads: 0
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Template
CMS Surgical Services Requirements Checklist
Use this checklist to assess compliance with CMS hospital surgical services requirements. It covers organization and staffing, circulating and scrub roles, surgical privileges, policies and protocols, informed consent, required equipment, and provisions for immediate postoperative care. Includes guidance on outpatient alignment with inpatient quality, PACU monitoring, and safety practices such as alcohol based skin prep risk reduction and surgical counts.
by Chad Niemeyer, from the Community
Downloads: 20+
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Template
Surgical Services Infection Prevention Audit
This surgical services infection prevention audit helps operating room teams verify compliance with hospital policies and best practices. It covers general infection control, proper PPE availability and use, hand hygiene, sink and scrub station supplies, and disinfectant readiness. Cleaning checks include dust control, air grills, equipment condition and stickers, OR turnover, and mattress integrity. Storage standards verify segregation of clean and dirty items, stock organization, temperature logging, and medication security. Sections for anesthesia cart readiness, waste and sharps management, soiled utility room practices, hallway and scrub area hygiene, and staff attire and workflow are included. Environmental controls confirm temperature, humidity, and air exchanges. Staff knowledge is assessed on hand hygiene, instrument care at point of use, and isolation identification.
by Mary Claire Horkay, from the Community
Downloads: 10+
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OR WalkRound Internal Audit Checklist

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Operating Room Internal Audit Checklist

UM WalkRound Cross Audit - Day Surgery

CMS Surgical Services Requirements Checklist

Surgical Services Infection Prevention Audit

You might also like

Operating Room Internal Audit Checklist

UM WalkRound Cross Audit - Day Surgery

CMS Surgical Services Requirements Checklist

Surgical Services Infection Prevention Audit