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Outgoing Checklist

This document is an outgoing checklist for nurses to ensure various areas of the facility are clean before ending their shift. It includes 20 items to check such as endorsements being clear, the examination room being replenished, common areas and sinks being cleaned, and floors being swept and mopped. Nurses must sign to confirm the checklist was fully carried out before concluding their duties.

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Joseph Roberto Caramat
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554 views1 page

Outgoing Checklist

This document is an outgoing checklist for nurses to ensure various areas of the facility are clean before ending their shift. It includes 20 items to check such as endorsements being clear, the examination room being replenished, common areas and sinks being cleaned, and floors being swept and mopped. Nurses must sign to confirm the checklist was fully carried out before concluding their duties.

Uploaded by

Joseph Roberto Caramat
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
  • Outgoing Checklist

OUTGOING CHECKLIST

________________________________________
(TODAY’S DATE)

Please check

1. Endorsements written on the logbook are clear and understandable.


2. Endorsements of previous duty had been carried out. Explanations why it was
not done should be written down beside the endorsement for clarity.
3. Outside vicinity is clean (including glass doors).

4. Signage lights are turned off.

5. Rubber mat has been placed outside.

6. Nurse’s table / Receiving area is clean.


7. Personnel’s CR is clean (no hair, bowl is clean).
8. Dra.’s room is clean.

9. Supplies in examination room were replenished.

10. Inventory (vaccines) were furnished.

11. Common CR is clean (no hair, bowl is clean).


12. Floor is swept and mopped clean.
13. Garbages are properly disposed and replaced with empty plastics.

14. Dining table is clean.

15. Sinks (washing – beside dining table) is clean.

16. Kitchen area is clean. xxxxxxxxxxx


a. Stove (on and under)

b. Sink (on and under)

17. Hand towels must have been replaced when dirty.


18. Kitchen floor is well swept and mopped.

19. Electric fans are clean (during Sundays only)


20. Cobwebs are removed (during Sundays only)

21. Surfaces (desks, TV, cabinets) are wiped clean (during Sundays only)

Checklist has been completely carried out.

_____________________ _____________________ ____________________


(Signatures of incoming nurses)

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