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Exam Room Stock Checklist
Year
*
2024
2025
2026
2027
Month
*
January
February
March
April
May
June
July
August
September
October
November
December
Exam Room
*
*
Cotton Balls
4x4 Gauze
Tongue Depressors
Band-aids
Spot Band-aids
Alcohol Pads
Scissors
Rectal and Oral Thermometer
Thermometer Probe Covers
Cotton Tipped Applicators
Wound Measuring Device
Diabetic Foot Tool
Lancets
2x3 Telfa
Tape
Pap Test Tubes
Small Vaginal Specs
Medium Vaginal Specs
Large Vaginal Specs
Lubricating Jelly
Pap Brushes
Antiseptic Towelettes
Gowns
Drapes
Pillow Cases
Table Paper
Ear Specs
Ear Curettes
Sterile H20, and Peroxide
Hemoccult Kits Exp Date:
Betadine Swabs Exp Date:
Alcohol Swabs Exp Date
Glove (Sm,Med,Lg Wall Mount)
Chux Pads
Kleenex
Sani-Cloths and Lysol Spray
Fill Ear Specs (Wall Mount)
Change Pillow Cases
Wipe Down Everything
Change Red Bag Trash
Change Sharps
Paper Towels
Hand Soap
Bacitracin Exp Date:
TAO Exp Date:
*
DM Refill Forms
BG Log
BP Log
Sliding Scale
Informed Consents for All Invasive Procedures
Informed Consents for Stimulants, Opioids, Bzo's, Gabapentin and Lyrica
Soap and COMM
Imaging Orders
Date Check Performed
*
+
Signature of Nurse Performing Check
*
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