Ambulatory Surgery Center Sterile Processing & Anesthesia Safety Checklist #30

This comprehensive ambulatory surgery center (ASC) checklist supports CMS ASC Conditions for Coverage (42 CFR 416) and Joint Commission accreditation readiness. It is designed for ASC leaders to verify pre-op readiness, sterile processing, anesthesia safety, infection prevention, and documentation across the perioperative workflow.

Industry: Healthcare
Frequency: Daily (each shift)
Estimated Time: 30-45 minutes
Role: ASC Administrator / OR Nurse Manager
Total Items: 35
Compliance: CMS ASC Conditions for Coverage 42 CFR 416, Joint Commission Ambulatory Care Standards (ASC), OSHA 29 CFR 1910.1030 Bloodborne Pathogens, AAMI ST79 Steam Sterilization (Healthcare Facilities), NFPA 99 Health Care Facilities Code (as applicable)

Pre-Op Readiness & Patient Identification

Verify pre-operative readiness, patient identification, consent, and baseline safety checks consistent with ASC policy and CMS 42 CFR 416 requirements.

Two patient identifiers verified before procedure?
Informed consent signed and in chart?
Correct site/side marked (as applicable) and verified?
Allergies reviewed and communicated to team?
Photo of completed pre-op checklist page (de-identified)

Time-Out & Surgical Safety Protocol

Confirm time-out execution, team communication, and availability of critical resources prior to incision/start of procedure.

Formal time-out performed with full team participation?
Procedure, laterality, and implants confirmed during time-out?
Specimen labeling plan confirmed (if applicable)?
Notes from safety briefing
Photo of time-out board or documentation (no PHI)

Instrument Reprocessing & Sterile Processing

Verify instrument decontamination, packaging, sterilization monitoring, and traceability per AAMI ST79 and CDC sterilization guidance.

Clean/dirty workflow separation maintained in SPD?
Manufacturer IFUs available and followed for complex instruments?
Sterilizer cycle parameters recorded and reviewed?
Sterile load traceability to cases maintained?
Photo of SPD workflow signage or logs

Anesthesia Equipment & Monitoring Safety

Assess anesthesia machine checks, airway readiness, monitoring, and medication safety consistent with facility policy and applicable standards.

Anesthesia machine check completed and documented?
Airway equipment and backup devices available?
Physiologic monitoring functional (SpO2, BP, ECG, EtCO2 as applicable)?
Crash cart present, sealed, and within inspection date?
Photo of anesthesia setup (no patient)

OR Infection Prevention & Environmental Controls

Verify aseptic practices, environmental cleaning, ventilation/temperature monitoring, and PPE usage aligned with OSHA BBP and CDC guidance.

Surgical attire and PPE used appropriately?
Terminal cleaning completed per schedule and documented?
Disinfectant contact time observed (surface wet time)?
OR temperature reading
Photo of cleaned OR ready state

Post-Op Recovery, Discharge & Handoff

Confirm PACU monitoring, pain management, discharge criteria, and patient education documentation for safe transitions of care.

PACU monitoring documented per policy?
Pain/nausea assessed and managed per protocol?
Discharge criteria met and documented?
Discharge instructions provided and teach-back documented?
Discharge notes / follow-up needs

Documentation, Incident Reporting & QAPI

Ensure required records are complete, incidents are reported, and issues feed into QAPI for continuous improvement and survey readiness.

Perioperative record complete (pre-op, intra-op, post-op)?
Sharps/regulated waste disposal compliant and documented?
Adverse events/near misses logged per policy?
Issues reviewed in QAPI committee and actioned?
Photo of de-identified log/board (if used)

Related Healthcare Checklists

Related Ambulatory Surgery Checklists

Why Use This Ambulatory Surgery Center Sterile Processing & Anesthesia Safety Checklist #30?

This ambulatory surgery center sterile processing & anesthesia safety checklist #30 helps healthcare teams maintain compliance and operational excellence. Designed for asc administrator / or nurse manager professionals, this checklist covers 35 critical inspection points across 7 sections. Recommended frequency: daily (each shift).

Ensures compliance with CMS ASC Conditions for Coverage 42 CFR 416, Joint Commission Ambulatory Care Standards (ASC), OSHA 29 CFR 1910.1030 Bloodborne Pathogens, AAMI ST79 Steam Sterilization (Healthcare Facilities), NFPA 99 Health Care Facilities Code (as applicable), CDC Guideline for Disinfection and Sterilization in Healthcare Facilities (2008). Regulatory-aligned for audit readiness and inspection documentation.

Frequently Asked Questions

What does the Ambulatory Surgery Center Sterile Processing & Anesthesia Safety Checklist #30 cover?

This checklist covers 35 inspection items across 7 sections: Pre-Op Readiness & Patient Identification, Time-Out & Surgical Safety Protocol, Instrument Reprocessing & Sterile Processing, Anesthesia Equipment & Monitoring Safety, OR Infection Prevention & Environmental Controls, Post-Op Recovery, Discharge & Handoff, Documentation, Incident Reporting & QAPI. It is designed for healthcare operations and compliance.

How often should this checklist be completed?

This checklist should be completed daily (each shift). Each completion takes approximately 30-45 minutes.

Who should use this Ambulatory Surgery Center Sterile Processing & Anesthesia Safety Checklist #30?

This checklist is designed for ASC Administrator / OR Nurse Manager professionals in the healthcare 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.