Surgical Site Infection Prevention Audit
Track surgical site infection prevention bundle compliance in one audit workflow. Verify antibiotic timing, normothermia, hair removal, glucose control, and skin prep before each case.
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Built for: Healthcare · Hospitals · Surgery Centers
What's inside this template
Preoperative Antibiotic Prophylaxis
- Appropriate prophylactic antibiotic selected per procedure protocol
- Antibiotic administered within recommended pre-incision window
- Antibiotic redosing addressed for prolonged cases or significant blood loss
- Documented allergy review completed before antibiotic administration
Normothermia Management
- Preoperative temperature assessed and documented
- Active warming used when indicated
- Intraoperative temperature maintained within target range
- Postoperative temperature documented in recovery
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Lowest recorded perioperative temperature
Enter the lowest documented temperature during the perioperative period.
Hair Removal Practices
- Hair removal avoided unless clinically necessary
- Approved hair removal method used when hair removal was required
- Hair removal performed as close to procedure time as possible
- Skin was not shaved with a razor
Perioperative Glucose Control
- Preoperative glucose checked for indicated patients
- Intraoperative or perioperative glucose monitoring completed as indicated
- Glucose remained within facility target range
- Hyperglycemia management documented when values exceeded target
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Highest documented perioperative glucose
Enter the highest documented glucose value during the perioperative period.
Skin Preparation and Surgical Site Readiness
- Surgical site skin prep product matches approved protocol
- Skin prep applied using correct contact time and drying time
- Prep area adequately covered intended incision and surrounding field
- No contamination of prepped field before incision
- Any break in skin prep technique documented and addressed
Common use cases
Frequently asked questions
What does this audit template help verify?
It checks key surgical site infection prevention steps against your facility protocol. Use it to confirm timing, documentation, and completion of bundle elements before, during, and after surgery.
Can this template be adapted to our hospital protocol?
Yes. Each section can be edited to match your approved antibiotic, warming, glucose, hair removal, and skin prep standards. You can also add facility-specific thresholds or required sign-offs.
Who should use this audit template?
It is suited for perioperative quality teams, infection prevention staff, and surgical leadership. It also works for unit managers reviewing case-level compliance and trends over time.
Does this template support documentation of exceptions?
Yes. It includes fields for items such as prolonged cases, blood loss, hyperglycemia, or breaks in technique. That makes it easier to record corrective actions and follow-up.
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