MINISTRY OF HEALTH

SCHOOL HEALTH DEPARTMENT

INFECTION CONTROL UNIT
INFECTION CONTROL CHECK LIST FOR SCHOOL HEALTH CLINIC

Region :

Area :

Name of the School :

Date :

Total Check List Standards ---------- Total Full Filled Standards ------------- Compliance % -------

SL CRITERIA YES NO N/A COMMENTS

NO
General physical environment is neat
1 and clean.
‫العياده مرتبه و نظيفه بشكل عام‬
Equipments are neat clean and infection
2 free
‫االجهزه نظيفه وتعمل بشكل جيد‬
Walls and floor are washable type and
3 free from stain ‫الحوائط و االرضيات قابله‬
‫للغسيل و خاليه من البقع‬
Posters on wall are either laminated or
have water proof cover. ‫اللوحات االرشاديه‬
4
‫مغلفه حراريا اوبالستيكيه‬

Windows are present for the clinic

5
.‫يوجد نافذه بالعياده‬
Windows are easy to open
6
.‫النافذه تعمله وسهله الفتح‬
Curtains are present it is clean and
7 free from dust and dirt
‫يوجد ستائر نظيفه و خاليه من االتربه‬
Floors are carpet free, dirt free and
clean by cleaners regularly( daily and
8
deeply cleaning weekly once
‫االرضيات يتم يوميا تنظيفها و أسبوعيا نظافه شامله‬
Partion screen is neat and clean if
9 made with cloth washes it through
school management ‫الساتر المتحرك نظيف‬
Ceiling and air vents are neat and
10 dust free
‫االسقف وفتحات تهويه المكيف نظيفه‬
Social distancing is maintained inside
11 the clinic
‫الحفاظ على تباعد المسافات داخل العياده‬
Every point of student care has
adequate Alcohol based hand rub
12 including dressing trolley and nurse’s

desk ‫توفير المطهر في أماكن سهله االستخدام‬

 A Poster demonstrating technique of
13 hand rub displayed in front of dressing
trolley ‫اللوحات االرشاديه الخاصه بتطهير االيدي‬

Minimum one wash basin is present in

14
the clinic ‫يوجد مغسله بالغرفه‬

Wash basin neat clean with water

15 facilities without any block or leak
‫المغسله نظيغه وتعمل بصوره جيده‬
Hand wash solution is present on a
16 stand near to the wash basin ‫توفير‬
‫الصابون السائل الخاص من الوزاره على الحوض‬
No hand rub( alcohol based solution ) is
17 present near to wash basin ‫ال يسمح بوجود‬
‫مطهر ايدي بجانب الحوض‬

Mirror with stand near to wash basin is

18 free of unwanted items ‫رف المرايا نظيف‬

Yellow box is present in second shelve

19 of the trolley ‫الصندوق األصفر على الرف التاني‬
‫على الترولي‬

Oxygen cylinder is kept near to head of

20
the bed‫اسطوانه االكسجين بجانب راس السرير‬
Paper towels are available in the hand
washing area and students care points
21
‫المناديل الورقيه متوفره‬

A Poster demonstrating technique of

hand wash displayed in front of wash
22
basin ‫اللوحات االرشاديه الخاصه بغسيل االيدي‬
‫موجوده بجانب الحوض‬
Waste bin foot operating type minimum
23 one is available for infectious waste.
‫متوفر حاويه ذات غطاء متحرك بالقدم‬
Waste bin for general waste is
24 present
‫حاويات القمامه العامه متوفره‬
Waste bin for toilet and wash area is
25 present
‫حاويه قمامه للحمامات و منطاق الغسيل متوفر‬
Adequate number of PPEs are available
26 for staff
‫الرقم المناسب من اعداد واقيات متوفر للعمال‬
Storage cupboard for medicine and
supplies is well arranged, dust free and
27 clean
‫دواليب تخزين االدويه مرتبه جيدا و خاليه من االتربه‬
‫و نظيفه‬
Storage cupboard for file is well
28 arranged, dust free and clean
‫خزائن الملفات مرتبه و خاليه من التربه و نظيفه‬
No items in the store room found on
floor or touched the roof and no spillage
29
present.
 Disposable sheets are not present on
30 shelves of cupboard or on refrigerator
.‫التوجد مفارش على االسطح او بداخل الخزانه‬
All supplies and medicines are within
31
expiry. ‫مراجعه تواريخ انتهاء االدويه‬
Dressing trolley is present and it is
32 neat ,clean and well arranged
‫ترولي الغيار نظيف مرتب‬
Dressing trolly has hibisol solution
33
‫مطهر االيدي متوفر على ترولي الغيار‬
Trays are label free, neat and clean
34
‫الصواني نظيفه وال يوجد عليها أي ملصقات تعريفيه‬
Nebulization can be kept second shelve
35
‫ممكن وضع جهاز التنفس في الدور التاني من الترولي‬
Disposable sheet on couch is present.
36
.‫المفرش ذات االستخدام الواحد متوفر‬
Refrigerator indicated for drugs and
37
supplies required for student care
Bathroom / toilets available and it is
39 neat and clean ‫يوجد حمام بداخل العياده‬

Oxygen humidifier empty dry and clean

40 ‫مرطب االكسجين فارغ وجاف ونظيف‬

Oxygen mask attached with cylinder

ready without opening
41
‫ماسك االكسجين جاهز بجانب االسطوانه‬

INFECTRION CONTOL PRACTICE STANDARDS

Appropriate Hand hygiene takes place

42 in accordance with moments of hand
hygiene with proper technique
PPEs are worn by health professional
43
when indicated with correct technique
Forceps and scissors are cleaned with
44 hand wash solution ( Hibiscrub) and
water
Waste management is being done
45
daily and whenever required
Sharp box is within the 3 months or
46 ¾th full after opening and mentioned
the opening date
Multi -dose syrups , ointments and
47 solutions are marked with date
opening
Grooming and appearance of staff is
48
professional neat and tidy
Nails of staff is cut short and no extra
49
make ups and polishes on nails
Immediate action and reporting on
needle stick injury and blood and body
50
fluids is known to staff and
completes when required
 FEED BACK REPORT TO THE DEPARTMENT

REGION ------------------------------------- DATE -----------------------------------

Areas of noncompliance by school nurse Recommendations for improvement by infection control

School nurse :

Clinical report

: ‫تقرير مفصل عن العياده‬

Infection control staff. Principal of the school