CHESP cheat sheet

Environment of care (EOC) is a continuous, multidisciplinary safety management process covering safety, security, hazardous materials, fire, medical equipment, and utilities-not a one-time inspection.

Life safety: exit routes must stay unobstructed; egress doors must open in the direction of travel without keys or special knowledge; exit signs and emergency lighting are tested on a defined schedule.

Fire safety: fire drills are documented with date, time, participants, and critique; drill frequency is set by the facility's policy and applicable codes (commonly quarterly per shift in high-risk occupancies).

Interim Life Safety Measures (ILSM) are required when fire protection features (e.g., sprinklers, alarms, fire-rated barriers) are impaired; ILSM includes surveillance, fire watch, and staff notification.

Infection prevention: standard precautions apply to all patients; transmission-based precautions (contact, droplet, airborne) add PPE, isolation, and ventilation requirements.

Hazardous materials: Safety Data Sheets (SDS) must be accessible for every hazardous chemical; spills follow spill-response procedures with PPE and reporting.

Security and violence prevention: workplace violence risk assessment, access control, and reporting of assaults are EOC components; staff must know how to summon help.

Utilities management: documented inspection, testing, and maintenance (ITM) of critical systems (medical gas, electrical, HVAC, water) with records retained for survey.

Cleaning is defined by soil removal; disinfection kills most pathogenic microorganisms on inanimate surfaces; sterilization destroys all microbial life-match the level to the surface and risk.

Spalding classification: critical items (entering sterile tissue) require sterilization; semicritical (contacting mucous membranes) require high-level disinfection; noncritical (intact skin contact) require low-level disinfection.

Contact time (dwell time) is the manufacturer-specified wet time a disinfectant must remain on the surface to achieve labeled efficacy; wiping dry early reduces kill.

High-touch surfaces (bed rails, call buttons, doorknobs, light switches, over-bed tables, IV poles) require more frequent cleaning than low-touch surfaces.

Terminal cleaning occurs after patient discharge or transfer and includes all surfaces, bed, bathroom, and high-touch items before the next occupant.

Staffing and productivity: workloading quantifies cleanable square footage and room types to set staffing; benchmark metrics include minutes per room and cleanable square feet per FTE.

Chemicals: dilution must follow manufacturer ratios; never mix incompatible products (e.g., bleach with ammonia or acid) due to toxic gas generation; store with SDS access.

Waste streams: regulated medical waste, general solid waste, and recyclables are segregated at point of generation; sharps go in puncture-resistant, closable containers.