Surgical Site Infection (SSI) Prevention Bundle Checklist [FREE PDF]
OR nurses and infection preventionists use this checklist per CDC Surgical Site Infection Prevention Guideline and CMS Hospital-Acquired Infection (HAI) reduction requirements.
- Industry: Healthcare / Surgery
- Frequency: Per Procedure
- Estimated Time: 5-10 minutes
- Role: OR Circulator Nurse
- Total Items: 8
- Compliance: CDC SSI Prevention Guideline, CMS HAI Measures
Preoperative SSI Bundle
Verify preoperative infection prevention measures.
- Was prophylactic antibiotic administered within 60 minutes before incision?
- Was surgical site skin preparation performed with alcohol-based antiseptic?
- If hair removal was necessary, was clipping used (not shaving)?
- Preoperative bundle notes
Intraoperative & Postoperative Measures
Verify intra-op and post-op SSI prevention measures.
- Is perioperative blood glucose being maintained below 200 mg/dL?
- Is patient normothermia maintained throughout the procedure?
- Was antibiotic redosed per guideline for procedures exceeding two half-lives?
- Intraoperative notes
Related Clinical Operations Checklists
- Central Line Insertion (CLABSI Prevention) Checklist [FREE PDF]
- ICU Infection Control and Patient Safety Daily Inspection Checklist
- Surgical Instrument Processing & Sterilization Checklist [FREE PDF]
- Endoscope Reprocessing & High-Level Disinfection Checklist [FREE PDF]
- Patient Fall Prevention Program Checklist [FREE PDF]
- Radiology Department Safety Program Checklist [FREE PDF]
- Patient Hand-Off Communication (SBAR) Checklist [FREE PDF]
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Related Infection Control Checklists
- ICU Infection Control and Patient Safety Daily Inspection Checklist - FREE Download
- Surgical Instrument Processing & Sterilization Checklist [FREE PDF] - FREE Download
- Endoscope Reprocessing & High-Level Disinfection Checklist [FREE PDF] - FREE Download
- Central Line Insertion (CLABSI Prevention) Checklist [FREE PDF] - FREE Download
Why Use This Surgical Site Infection (SSI) Prevention Bundle Checklist [FREE PDF]?
This surgical site infection (ssi) prevention bundle checklist [free pdf] helps healthcare / surgery teams maintain compliance and operational excellence. Designed for or circulator nurse professionals, this checklist covers 8 critical inspection points across 2 sections. Recommended frequency: per procedure.
Ensures compliance with CDC SSI Prevention Guideline, CMS HAI Measures. Regulatory-aligned for audit readiness and inspection documentation.
Frequently Asked Questions
What does the Surgical Site Infection (SSI) Prevention Bundle Checklist [FREE PDF] cover?
This checklist covers 8 inspection items across 2 sections: Preoperative SSI Bundle, Intraoperative & Postoperative Measures. It is designed for healthcare / surgery operations and compliance.
How often should this checklist be completed?
This checklist should be completed per procedure. Each completion takes approximately 5-10 minutes.
Who should use this Surgical Site Infection (SSI) Prevention Bundle Checklist [FREE PDF]?
This checklist is designed for OR Circulator Nurse professionals in the healthcare / surgery industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.
Can I download this checklist as a PDF?
Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.