Skin Penetration Audit Tool Form
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1
2Skin Penetration Audit Tool
Premises Name: _______________________________________________________________________
Address: _____________________________________________________________________________
Owner/Manager: ____________________________________Telephone: _________________________
Procedures conducted: (please circle) tattooing / body piercing / body modification / beauty / colonic
lavage / waxing /electrolysis / cosmetic tattooing / dry needling / other:______________________________
1.
Premises design & hygiene
For sterilisation of articles
:
a.
Is the premises clean/hygienic
Yes/No
b.
Use detergent & water to clean?
Yes/No
b.
Equipment clean, dry & in good
c.
Physical/mechanical action?
Yes/No
working order
Yes/No
d.
Rinsed with warm or hot water?
Yes/No
c.
Structurally suitable
Yes/No
e.
Dried with lint free cloth or drying
d.
Hand wash basin (HWB)
cabinet?
Yes/No
i)
Is provided on premises
Yes/No
f.
Ultra-sonic cleaner used?
Yes/No
ii)
Clean, warm, potable water
Yes/No
g.
Operated correctly/clean?
Yes/No/NA
iii)
Through single spout
Yes/No
h.
Foil test conducted regularly?
Yes/No/NA
iv) Liquid soap or alcohol cleanser Yes/No
i.
Disinfectant used?
Yes/No
v)
Single use towels or hand
i) Instrument grade
Yes/No
dryer at HWB
Yes/No
ii) Type: ___________________
e.
Separate sink for cleaning with
j.
Articles used in skin penetration must
warm water
Yes/No
have been sterilised and kept in sterile
f.
Disposable gloves, clean linen and
condition
Yes/No
gowns or aprons (available)
Yes/No
k.
Bench-top steriliser used
Yes/No
g.
Supply of sterile disposable
l.
Is there manual recording of the steriliser or
needles (if needles are used)
Yes/No/NA
Is there a print out recorder (as per the
h.
Dirty & clean areas separated
Yes/No
Regulation and AS 4815:2006)
Yes/No
i.
Adequate No. toilets (Col. lavage)
Yes/No/NA
m. Are items packaged appropriately
Yes/No
n.
Training in use of steriliser
Yes/No
2.
Treatment/procedures/PPE
o.
Sterilisation records
a.
All needles MUST BE single use
Yes/No/NA
i)
time and date
Yes/No
b.
Sterile gloves used for contact with
ii) temperature and pressure levels Yes/No
sterile items and sterile tissue
Yes/No/NA
iii) length of time autoclaved
Yes/No
c.
Single use gloves used for skin
iv) maintenance records
Yes/No
penetration procedures
v) performance validation (yearly)
Yes/No
(exemption for waxing see note e)
Yes/No
p.
Record of date sent off site, and
d.
Apron or gown used during skin
name & address
Yes/No
penetration procedures
q.
Sterilisation records kept for
(exemption for waxing see note e)
Yes/No
12 months
Yes/No
e.
Hands washed between clients
Yes/No
r.
Storage of packaged items in clean,
f.
Premises conduct waxing? (if No
dry area away from sunlight
Yes/No
Go to h)
Yes/No
s.
Packaged items in good condition
Yes/No
g.
How is wax dispensed?
t.
Items sterilised off site
Yes/No
i)
Spatulas disposed after use
Yes/No
ii)
Is all applied wax disposed
4.
Waste
after each client? (roll on
a.
Waste disposal bin
Yes/No
single use)
Yes/No
b.
Sharps disposed into sharps
h.
Ink, pigment or other liquid (not wax)
container immediately after use?
Yes/No/NA
dispensed into single use containers
c.
Sharps container collected by a
& single use applicator used
Yes/No/NA
licensed contractor?
Yes/No/NA
i.
Is skin antiseptic used?
Yes/No/NA
d.
Clinical waste generated
Yes/No
e.
Clinical waste bin provided
Yes/No
3.
Cleaning and sterilisation
f.
Clinical waste contractor
Yes/No
a.
All reusable instruments which
penetrate the skin sterilised
Yes/No/NA
7/2/13 v2
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