Skin Penetration Audit Tool Form Page 2
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1
2g.
Contractor details:
Name: __________________________________
Sterilisation/
Single
Clean
Disinf
Sterile
Address: ________________________________
disinfection
Use
________________________________________
Cuticle cutters/
Telephone number: _______________________
nippers
Lances
5.
Education
a.
Are you aware of the NSW Health educational
Nail files
resources e.g. fact sheets on the website
Needles
Yes/No
(including botox)
6.
Comment(s):
Razor scrapers
________________________________________
________________________________________
Tweezers
________________________________________
Waxing spatulas
________________________________________
________________________________________
Derma-rollers
________________________________________
Microdermabrasion
________________________________________
heads
________________________________________
Cosmetic tattooing
________________________________________
needles
________________________________________
Foot spa (see fact
________________________________________
sheet)
________________________________________
Electrolysis
needles
Tattoo needles
7.
Action(s):
________________________________________
Tattoo machine
________________________________________
head
Sponge/cloth to wipe
________________________________________
tattoo site
________________________________________
Clamps
________________________________________
________________________________________
Sterile gloves
________________________________________
Forceps
________________________________________
________________________________________
Jewellery for
________________________________________
(piercing)
________________________________________
Scalpel
________________________________________
Sterile field ‘pack’
________________________________________
Needles
8.
Authorised Officer
Tubing
Name:__________________________________
Speculum
9.
Date/Time:
________________________________________
Notes:
7/2/13 v2a
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