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Procedure Room #1 Stock Checklist
Year
*
2016
2017
2018
2019
2020
2021
2022
2023
Month
*
January
February
March
April
May
June
July
August
September
October
November
December
*
Cotton Balls
4x4 Gauze
Tongue Depressors
Band-aids
Spot Band-aids
Alcohol Pads
Scissors
Oral Thermometer
Thermometer Probe Covers
Cotton Tipped Applicators
Hemoccult Cards and Buffer
Wound Measuring Device
Diabetic Foot Tool
2x3 Telfa
Tape
Pap Test Tubes
Small Vaginal Specs
Medium Vaginal Specs
Sutures
Knuckle Bandaids
Sterile Drapes
Punch Biopsies
Dermal Blade
Dermal Curette
4x4 Sterile Tray
Lidocaine w/Epi
Lidocaine 1% and 2%
Syringes (3cc-5cc)
Needles (18g, 27g, 30g)
15 blade
11 blade
Surgical Trays
Large Vaginal Specs
Lubricating Jelly
Pap Brushes
Antiseptic Towelettes
Gowns
Drapes
Pillow Cases
Table Paper
Ear Specs
Ear Curettes
Alcohol, Betadine, Sterile H2O and Peroxide
Hemoccult Kits
Aero/Anaero Culture Swabs
6.5 Sterile Gloves
7.5 Sterile Gloves
Ace Bandages
Kerlix Rolls
Face Masks
Provider Gown
Shoe Covers
Mask w/Shield
Telfa Dressing
Cold Spray
Sterile Scissor & Tweezer Sets
Sterile Scissors
Sterile Tweezers
Sterile Hemostats
Abdominal Pads
Chlorahexadine, Alcohol and Betadine Swabs
Blue Chux
Iodoform Packing
Vaseline Gauze
Gloves (Sm,Md,Lg) Wall Mount
Sani-Cloth
Kleenex
Lysol
Fill Ear Specs (Wall Mount)
Change Pillow Case
Wipe down everything
Change Red Bags
Change Sharps
Paper Towels
Hand Soap
*
DM Refill Forms
BG Log
BP Log
Sliding Scale
BMI Education
Informed Consents for All Invasive Procedures
Informed Consents for Stimulants, Opioids, Bzo's, Gabapentin and Lyrica
Soap and COMM
Imaging Orders
Notes:
Date Check Performed
*
+
Signature of Nurse Performing Check
*
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