Clinical Shift Safety Checklist Form
Complete this checklist before or during your clinical shift to ensure a safe and prepared environment. All items are required for shift readiness.
Full Name
*
First Name
Last Name
Shift Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Shift Type
*
Please Select
Day Shift
Evening Shift
Night Shift
Personal Protective Equipment (PPE) available and in good condition
*
Yes
No
Emergency equipment checked and accessible (e.g., defibrillator, oxygen, suction)
*
Yes
No
Medications and supplies stocked and not expired
*
Yes
No
Work area clean, organized, and free of hazards
*
Yes
No
Communication devices (phones, pagers) functional and accessible
*
Yes
No
Additional comments or issues noted
Submit Checklist
Should be Empty: