Healthcare-associated infections (HAIs) remain one of the most significant threats to patient safety worldwide. According to global health authorities, millions of patients are affected by HAIs each year, leading to prolonged hospital stays, increased antimicrobial resistance, higher mortality rates, and substantial financial burden on healthcare systems. A rigorous infection prevention and control (IPC) program, supported by systematic auditing, is the most effective defense against these preventable infections.
This hospital infection control audit checklist provides infection preventionists, quality managers, and clinical leaders with a structured tool for evaluating compliance with IPC best practices. Regular auditing identifies gaps in practice, reinforces standards, and drives a culture of infection prevention across the organization.
Why Infection Control Audits Matter
Infection control audits serve as the quality assurance mechanism for IPC programs. Without regular assessment, even well-designed protocols can erode as staff turnover, complacency, and competing priorities take hold. Audits provide objective evidence of compliance levels, identify high-risk areas requiring intervention, and measure the effectiveness of improvement initiatives. Regulatory and accreditation bodies including the Joint Commission, CMS, and WHO consider active surveillance and auditing as essential components of an effective IPC program. Hospitals that demonstrate strong audit programs consistently achieve lower HAI rates and better patient outcomes.
Hospital Infection Control Audit Checklist
1. Hand Hygiene Compliance
Hand hygiene is universally recognized as the single most important measure for preventing the transmission of pathogens in healthcare settings. Audit programs should use direct observation, product usage data, and electronic monitoring where available to assess compliance.
- Conduct direct observation audits of hand hygiene at the five moments defined by the WHO framework
- Verify that alcohol-based hand rub dispensers are functional, filled, and accessible at all points of care
- Check that handwashing sinks are equipped with soap, running water, and single-use towels
- Review hand hygiene compliance data trends and verify that results are fed back to individual units
- Confirm that hand hygiene training is included in new employee orientation and annual competency programs
2. Personal Protective Equipment Usage
Correct selection, donning, doffing, and disposal of personal protective equipment (PPE) is essential to protect both healthcare workers and patients from pathogen transmission. Auditing PPE practices helps identify training gaps and supply issues.
- Observe staff donning and doffing PPE and assess compliance with the facility's standard precautions policy
- Verify that appropriate PPE types and sizes are stocked and readily available in clinical areas
- Confirm that PPE signage is posted at isolation room entrances with clear instructions for required equipment
- Review PPE training records and ensure all clinical staff have documented competency assessments
3. Environmental Cleaning and Disinfection
Contaminated environmental surfaces serve as reservoirs for healthcare-associated pathogens. Effective cleaning and disinfection programs target high-touch surfaces and use products with demonstrated efficacy against relevant organisms.
- Audit cleaning frequency and thoroughness for high-touch surfaces in patient rooms, restrooms, and common areas
- Verify that terminal cleaning protocols are followed for discharge and transfer rooms including contact precaution rooms
- Check that cleaning products are EPA-registered and used according to manufacturer contact time instructions
- Review fluorescent marker or ATP bioluminescence monitoring results to objectively measure cleaning effectiveness
- Confirm that environmental services staff receive initial and ongoing training on infection control cleaning procedures
4. Sterilization and High-Level Disinfection
Reusable medical devices that contact sterile body sites or mucous membranes must be reprocessed using validated sterilization or high-level disinfection methods. Failures in reprocessing can transmit bloodborne pathogens and multi-drug resistant organisms.
- Verify that sterilizer qualification including biological indicator testing is performed at required intervals
- Check that instrument cleaning, inspection, packaging, and loading procedures follow manufacturer IFU
- Review chemical indicator and biological indicator records for any failures and associated corrective actions
- Confirm that sterile storage areas maintain appropriate temperature, humidity, and access controls
5. Isolation and Transmission-Based Precautions
Transmission-based precautions supplement standard precautions for patients known or suspected to be infected with pathogens that require additional control measures. Proper implementation prevents outbreaks and protects vulnerable patients.
- Verify that isolation orders are initiated promptly based on clinical presentation and laboratory results
- Check that isolation signage is correctly posted and specifies the required precaution category
- Confirm that dedicated or disposable patient care equipment is available in isolation rooms
- Audit visitor screening processes and verify that visitors receive instructions on required precautions
6. Antimicrobial Stewardship
Antimicrobial stewardship programs work hand in hand with infection control by promoting the appropriate use of antibiotics. Overuse and misuse of antimicrobials drives resistance, making HAIs more difficult to treat.
- Review antimicrobial prescribing data for compliance with institutional guidelines and formulary restrictions
- Verify that prospective audit and feedback or pre-authorization programs are active and documented
- Check that antibiogram data is current and distributed to prescribers to guide empiric therapy decisions
- Confirm that de-escalation and IV-to-oral conversion protocols are in place and routinely followed
Best Practices for Infection Control Audits
- Conduct audits using a combination of direct observation, record review, and environmental sampling methods
- Provide timely, unit-specific feedback to frontline staff to reinforce positive behaviors and correct deficiencies
- Integrate audit findings into the hospital's quality improvement framework with measurable goals and timelines
- Engage multidisciplinary teams including physicians, nurses, environmental services, and administration in audit review
- Benchmark audit results against national databases such as NHSN to contextualize facility performance
- Use audit data to inform targeted education campaigns and resource allocation decisions
How Checksheets Helps
Checksheets empowers infection prevention teams with digital audit tools designed for the fast-paced hospital environment. Build custom audit templates for hand hygiene, PPE, environmental cleaning, and any other IPC focus area. Conduct observations directly on a tablet or smartphone, with results automatically compiled into trend reports and unit-level dashboards. Our platform supports real-time data sharing with clinical leadership, enabling rapid response to emerging compliance issues. Replace clipboard audits with a system that turns data into actionable improvement.
Infection prevention is a shared responsibility that requires constant vigilance and measurement. A structured audit program, powered by digital tools, provides the visibility and accountability needed to protect patients from healthcare-associated infections. Begin your infection control audit program today and make your hospital safer for every patient and every care team member.