Template

Patient Lifter Environmental Stress Cracking Audit

10+

This visual audit template helps health services inspect patient lifters for environmental stress cracking and improve equipment safety. It guides teams to record principal cleaning and disinfectant products, cleaning frequency and dilution, recent regime changes, and staff training updates. Auditors can document reported damage frequency, define ESC severity levels, capture brand and model, purchase year, and attach photos to support maintenance and compliance across hospital departments.

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Eliminate mistakes made by paper-based processes

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Confirm accountability and compliance with a digital log

With SafetyCulture you can

Digitize any process, procedure or policy

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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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

Environmental Stress Cracking Site Audit

Use this visual site audit to assess environmental stress cracking across hospital departments. Capture background details, cleaning and disinfectant products in use, and any safety issues linked to those agents. Coordinate inputs from maintenance, support services, biomedical engineering, and clinical teams. Inspect medical devices and infrastructure such as infusion pumps, patient lifters, monitors, outlets, and carts. Rate the extent of cracking, add photos, list brands and models, and record contact information to support follow-up actions.

by Nick keogh, from the Community

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Template

Infusion Pump Environmental Stress Cracking Audit

This healthcare audit template helps clinical engineering and nursing teams assess infusion pumps for environmental stress cracking. It guides users to review cleaning and disinfectant products in use, capture frequency and process details, and document any changes to cleaning regimes or training. Inspectors can evaluate pump components, record ESC indicators such as brittle or hairline cracks, attach photos, and rate severity from minor to severe across departments. The checklist supports consistent documentation to improve device safety, maintenance decisions, and compliance in hospital settings.

by Nick keogh, from the Community

10+

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Template

HSE Stress Risk Assessment

This HSE stress risk assessment template is used to identify work-related stress, anxiety and depression across your workplace employees. Use SafetyCulture to record stress-causing factors, improve employee morale, boost job productivity and create a safer and stress-free environment.

by SafetyCulture

300+

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Template

Patient Visitation / Cleanliness Evaluation - EVS**

This document outlines a structured approach for Environmental Services (EVS) preceptors to evaluate room cleanliness and patient satisfaction in hospital settings. It includes a patient satisfaction questionnaire, visual observation checklist, and assessment criteria for multiple hospital service areas. The evaluation covers housekeeping interactions, room and restroom cleanliness, and identifies areas for improvement across nursing, facilities engineering, food and nutrition, and environmental services departments. The form emphasizes professional customer service and ensures consistent quality standards in healthcare facility maintenance.

by James Rose, from the Community

40+

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Template

Workplace Stress Risk Assessment Template

Use this workplace stress risk assessment to evaluate key factors that drive stress at work: demands, control, support, relationships, role clarity, and change. Record evidence, consult staff, and prioritize actions to reduce risks and support wellbeing. Ideal for HR, managers, and safety leaders to review workloads, communication, training, and policies, and to monitor progress over time.

by Graham Plumbe, from the Community

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Template

Infection Control Environmental Round Discrepancy List

This infection control environmental rounds checklist helps hospitals identify and track discrepancies across patient and non patient care areas. Sections cover safety management, hazardous materials, environmental services, general maintenance, and detailed infection control practices. Items include PPE availability, hand hygiene, refrigerator labeling and logs, sterile storage, linen handling, isolation signage, and equipment cleaning. Designed to support Joint Commission compliance and patient safety.

by J Brothman, from the Community

70+

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