Surgical Site Infection Prevention Audit

Audit template for verifying compliance with surgical site infection prevention bundle elements, including antibiotic timing, normothermia, hair removal, glucose control, and skin preparation.

Audit Details

• Procedure type and surgical service documented
• Date and time of audit recorded
• Auditor name and role recorded
• Source records reviewed identified

Preoperative Antibiotic Prophylaxis

• Prophylactic antibiotic ordered for procedure when indicated
• Antibiotic administered within the facility-defined pre-incision window
• Antibiotic administration time documented
• Incision time documented for comparison
• Appropriate redosing documented for prolonged case or blood loss when applicable

Normothermia Management

• Preoperative temperature assessed
• Active warming device used when indicated
• Intraoperative temperature maintained within facility target range
• Temperature monitoring documented at appropriate intervals

Hair Removal Practices

• Hair removal performed only when clinically indicated
• If hair removal was performed, method was clipper rather than razor
• Hair removal occurred immediately before surgery when indicated

Perioperative Glucose Control

• Preoperative glucose measured when indicated
• Glucose value within facility target range or addressed by protocol
• Insulin or corrective treatment documented when indicated
• Repeat glucose monitoring documented after intervention when applicable

Skin Preparation and Surgical Site Readiness

• Surgical site skin prep agent matches facility protocol
• Skin prep applied using correct contact time and drying time
• Surgical site free of contamination before incision
• Site marking and laterality verified when applicable