School Health Clinic Checklist

Facility name
Physical Location
Facility hours
License No.
Date & Time
Audit Type: Renewal Concise/Follow up Adhoc
Name Title/License no. Name Title/License no.

HAAD Auditor HAAD Auditor

Name: Name:
Division: Division:
Auditor No.: Auditor No.:

International Patient Safety Goals

1. Improve the accuracy of patient identification

2. Improve the effectiveness of communication among care givers and care recipients
3. Improve the safety of using medications and medical devices
4. Reducing the risk of healthcare associated infections
5. Ensuring correct site, correct procedure, correct patient for all procedures
6. Accurately and completely reconcile medications across the continuum of care
7. Encourage patients active involvement in their own care as a patient safety strategy
8. Improve recognition and response to changes in a patients condition
9. Reducing risk of patient harm resulting from falls
10. Reduce the risk of hospital fires

P = PRIORITY PSG = PATIENT SAFETY GOALS

No. Ref Auditor Tasks Yes Partial No PSG Comments

English
A Medical equipment and
furniture
1 Equipment checked on
scheduled basis &
results documented/
signed by school nurse
2 Desks and chairs

3 Filing cabinet
4 At least one
examination/patient
couches (medical grade )
height adjustable)
(
1
5 Portable screen (if there )
is no separate
observation or (
treatment room)
6 Lockable medication 3
cabinet
7 Telephone with external 1, 2
facilities (outside line)
8 Liquid soap dispenser 4
with undiluted soap
9 Disposable paper hand
towel or electric hand
dryer
10 Refrigerator to store
medications with built-
in thermometer
Note: Food must be
kept in a separate :
refrigerator


11 Medical grade weighing
scale with height
measurement
12 Medical grade footstep

13 Examination light
14 Sphygmomanometer )
(with paediatric and
adult cuffs) (
15 Glucometer

16 Stethoscope
17 ENT diagnostic set
(otoscope),ophthalmosc )
ope (
18 Thermometer )
(
19 Torch with extra set of
batteries
20 20-foot Snellen Vision
chart -
21 Occluders for vision
testing
22 Oxygen cylinder with a
P regulator and a
humidifier. Used only by
a suitably trained
licensed Healthcare
professional

2
23 Nebulizer
P
24 Wheel chair

25 Stretcher

26 Stainless steel two /

shelves dressing trolley

27 Scissor

28 Cotton swab drum

29 Foot operated covered

waste disposable bin
30 Vaccine carrier/ box /

31 Tape measure
32 Tweezers/ pick-ups /

33 Audiometer or access
to audiometer
(dependent on HAAD
)
screening guidelines)
(
B Medical consumables
1 Examination paper
2 Cold compresses
3 Cotton balls
4 Drinking cups (6 boxes) 6) (
5 Disposable oxygen
P masks- different sizes
6 Disposable gloves
latex free
7 Disposable tongue
depressors
8 Bandage different sizes
9 Sterile gauze
10 Disposable dressing sets
11 Adhesive tape
12 Disinfectant suitable for
thermometers
13 Cotton blankets (2) 2

3
C Medical Records
1 Medical records
available for each
student
2 Student identified with
unique number
3 For clinics a log book/
register is maintained
for all students
4 Student care
documented, dated and
signed, consent form
signed
5 Records are kept in
secure manner/
confidentiality of
student information in
lockable metal cabinet
6 Student referral process
in place with
documentation
maintained
D Complaint management

1 Student/patients rights
and
responsibilities/patient
charter including details
on how to make a
complaint is displayed
in the school clinic
2 The school clinic staff
can demonstrate
knowledge and
implementation of the
complaint system.
E Physical Requirement
1 School clinic is suitable
for scope of work

2 All physical spaces meet

the minimum
requirements for the
clinic service (40 sq.m
for school up to2000 40)
students and for every 2000
additional 1,000

4
 students additional 1000
room of 20 sq.m 20
.(

3 Services should be :
located on the Ground
floor and be easily
accessible.
4 Attached W.C
5 Sufficient lighting (300- 350 -300)
350 Lux) (
6 Good heating/ lighting/ / /
ventilation with proper
air conditioning
7 Separate designated
waiting area to
accommodate at least
five students
8 Hand washing sink
9 Signage system
F Manpower

1 Registered Nurse with ALL

current license full
time
2 Physician with current ) ALL
license part time
(optional does not
replace the need for an
RN unless fulltime) (
3 License for health care 2
facility is displayed
4 Full time availability for
the nurse and in case of
her absence there is a
suitable alternative
person available
5 Job description defined
and nurses working to
their specialty

6 Malpractice insurance ( )
for Physician and the (
nurse in SEHA facilities)
7 Staff are appropriately
attired and wear ID

5
 badges

G Infection Control

1 School clinic in clean 4

and sanitary condition

2 Infection control policies
and standards are
adhered to as
appropriate for scope of
service
3 Safe Sharps disposal and 4
practices followed

4 Medical waste 4
containers stainless
steel with foot control
and with cover

5 Waste management ) 4
process in place
( Coloured
bags/labelled/disposal)
(
6 Personal protective 4
equipment available
7 Good hand hygiene and 4
cleaning practices
followed as per HAAD
Polices and Standards

8 Single use/disposable 4
latex free supplies used

9 Reporting mechanism 4 4
for communicable
diseases followed and
documented
10 All staff working in 4 4
the clinic received
training in infection
control.
11 Hand sanitizer is
6
 available
H Fire Safety
1 Smoke detectors
working

2 Electrical
bars/extension cords
secure and expectable
I FIRST AID
1 First aid boxes available 3.5
in appropriate places
throughout the facility



2 Contents adequate for
number of staff and
students and no
unapproved content
present (e.g. medicines
etc.)
3 Expired contents
replaced before expiry
date ( one month)

4 Ice packs and cooler
5 Adequate number of 3.5 3,5
basic life support (BLS)
certified first aid
providers (at least 4%) )
available at the school
during the school day ( %4
and on school trips


6 Medicines (including (
any epi-pens etc.) )
stored appropriately
labelled in locked
cupboard

J Medications ()

1 Medications are 3.5

appropriate for scope of )
service (as detailed in
HAAD school medication
7
 policy) (

2 Medication practices 3.5

comply with staff license

3 Medications stored
correctly in clinic area

4 Qualified physicians 3.5
writing prescriptions
(using HAAD Standard
Prescription)
(
5 Policies/procedures in
place for management
of medications/signed
off by staff
6 Competency program 3.5
for staff on medication
usage/practices (as per
school medication )
policy)

(
7 System in place for
tracking the expiry date
of medication
K Clinical Practice

1 Drs/Nurses/Technicians
working according to
their professional
license and privilege
2 Process in place to list
the procedures that the
physician/ nurse is
allowed to do (job )
description) (
3 Clinical practice
guidelines in place
4 Physician order sheets
and progress notes in
place and nursing notes
5 Student
education/information
provided on condition/
treatment/ / / /

8
 medications/ follow-up
6 Follow up care
documented
7 Student privacy and
confidentiality provided 1.2

Tota Met Partially Met Not Met N/A

l
Prio
rity
Non
prio
rity

School Health Clinic HAAD Auditor

Name: Name:
Signature: Signature:
Date: Date:

Section Head Comments:

...

Name: Signature: . Date .