Checklist template

Operatory setup and turnover for dental practices

A ready-to-use checklist with 114 items in 6 sections, covering Setup, Barriers, Turnover, Supplies, Equipment, Waterlines. Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 6 Sections
  • 114 Items
  • 101 Yes / No checks
  • 6 Scored ratings
  • 131 Points

Use this template How audits work

1. Setup 21 items

  1. Tray setups for the morning were pulled from the day's schedule before the first patient Yes / No 1 pt
  2. The tray or cassette set out for the next patient matches the scheduled procedure Yes / No 1 pt
  3. Instrument pouches stay sealed until the patient is seated Yes / No 1 pt
  4. The previous patient's chart and radiographs are closed on the operatory monitor before the next patient enters Yes / No 1 pt
  5. The assistant reviews the medical alerts of the patient before seating Yes / No 1 pt
  6. A new patient bib and bib clip or disposable holder are ready at the chair Yes / No 1 pt
  7. Protective eyewear for the patient is set out Yes / No 1 pt
  8. A new saliva ejector and high-volume suction tip are fitted for each patient Yes / No 1 pt
  9. The air/water syringe tip is new or sterilized for each patient Yes / No 1 pt
  10. Unit-dose materials are dispensed before the procedure starts Yes / No 1 pt
  11. Clean cotton pliers are set out to retrieve items from drawers during the procedure Yes / No 1 pt
  12. Anesthetic cartridges and needles are set out for the patient in the chair only, not preloaded for the day Yes / No 1 pt
  13. Burs for the procedure come from a sterilized bur block Yes / No 1 pt
  14. Handpieces fitted to the unit come from a sealed sterilization pouch Yes / No 1 pt
  15. The lab case for a seat appointment is in the operatory before the patient is seated Yes / No 1 pt
  16. The chair is in the entry position with the armrest raised Yes / No 1 pt
  17. Hoses and the foot control are clear of the patient's path to the chair Yes / No 1 pt
  18. Instruments and materials for the procedure are laid out on the tray in the order of use Yes / No 1 pt
  19. The opening checklist of each operatory is initialed for today Yes / No 1 pt
  20. Minutes between the scheduled time and the seating of the patient observed Number
  21. Readiness of the operatory when the patient was seated Rating
    • Complete, nothing fetched afterward 5 pts
    • One or two items fetched afterward 3 pts
    • Setup incomplete 1 pt

2. Barriers 17 items

  1. Light handles are covered with a barrier Yes / No 1 pt
  2. The headrest is covered with a barrier Yes / No 1 pt
  3. The air/water syringe handle and buttons are covered with a barrier Yes / No 1 pt
  4. The suction hose handles are covered with a barrier Yes / No 1 pt
  5. Chair control buttons or the touchpad are covered with a barrier Yes / No 1 pt
  6. The X-ray tube head and exposure switch are covered with a barrier when radiographs are planned Yes / No 1 pt
  7. The keyboard and mouse have a wipeable cover or a barrier Yes / No 1 pt
  8. The curing light has a new sleeve for each patient Yes / No 1 pt
  9. The intraoral camera has a new sheath for each patient Yes / No 1 pt
  10. The digital X-ray sensor has a new sheath for each patient Yes / No 1 pt
  11. The bracket table handle is covered with a barrier Yes / No 1 pt
  12. Barriers in place show no tears or gaps Yes / No 1 pt
  13. Barriers are placed with clean hands after the disinfected surface has dried Yes / No 1 pt
  14. Used barriers are removed with gloved hands before surfaces are wiped Yes / No 1 pt
  15. The surface under a barrier found torn is cleaned and disinfected before the next patient Yes / No 1 pt
  16. Each operatory holds its own stock of barrier film, sleeves and sheaths Yes / No 1 pt
  17. Barrier coverage in the operatories checked Rating
    • Every touch surface covered 5 pts
    • One or two surfaces missed 3 pts
    • Several surfaces missed 1 pt

3. Turnover 21 items

  1. Used needles and blades go into the sharps container in the operatory before the tray is moved Yes / No 1 pt
  2. Partly used anesthetic cartridges are discarded, never kept for another patient Yes / No 1 pt
  3. Disposable items on the used tray are discarded in the operatory before the tray leaves Yes / No 1 pt
  4. Blood-soaked items go into the biohazard waste container as required by local regulation Yes / No 1 pt
  5. Handpieces are run for 20 to 30 seconds to flush the lines before they are removed Yes / No 1 pt
  6. Water is drawn through the suction hoses between patients Yes / No 1 pt
  7. Surfaces are wiped once to clean, then wiped again with a fresh wipe to disinfect Yes / No 1 pt
  8. Disinfected surfaces stay visibly wet for the contact time stated on the product label Yes / No 1 pt
  9. The employee asked could state the contact time of the disinfectant in use Yes / No 1 pt
  10. The disinfectant wipe canister is kept closed between uses Yes / No 1 pt
  11. The employee doing the turnover wears a mask Yes / No 1 pt
  12. The employee doing the turnover wears protective eyewear Yes / No 1 pt
  13. Utility gloves or fresh exam gloves are worn to handle the used tray Yes / No 1 pt
  14. Chair armrests and the seat edges are wiped at each turnover Yes / No 1 pt
  15. Patient protective eyewear is disinfected after each patient Yes / No 1 pt
  16. The floor around the chair is checked for dropped materials at each turnover Yes / No 1 pt
  17. Drawers and clean supplies are not touched with contaminated gloves during the turnover Yes / No 1 pt
  18. The closing checklist of each operatory was initialed yesterday Yes / No 1 pt
  19. Operatories checked during the visit Number
  20. Minutes taken by the turnover observed Number
  21. Turnover observed Rating
    • Full sequence followed 5 pts
    • Steps shortened 3 pts
    • Steps skipped 1 pt

4. Supplies 17 items

  1. A standard stock list is posted inside a cabinet of each operatory Yes / No 1 pt
  2. Drawers are laid out the same way in every operatory Yes / No 1 pt
  3. Exam gloves are stocked in the operatory in each size worn by the team Yes / No 1 pt
  4. Masks of the level set by company policy are stocked in each operatory Yes / No 1 pt
  5. Operatories are restocked at the end of the day, not during patient care Yes / No 1 pt
  6. Opened single-use disposables (prophy angles, impression trays) are never put back in the drawer Yes / No 1 pt
  7. Composite syringes and compules are capped and kept away from the operating light Yes / No 1 pt
  8. Bottles with a shelf life after opening carry the date they were opened Yes / No 1 pt
  9. Materials decanted from bulk containers are in labeled containers Yes / No 1 pt
  10. Cotton rolls and gauze are kept in covered dispensers Yes / No 1 pt
  11. Topical anesthetic is taken from the jar with a new applicator each time Yes / No 1 pt
  12. Procedure tubs are complete against the content list on their lid Yes / No 1 pt
  13. Soap, hand sanitizer and paper towel dispensers in the operatory are filled Yes / No 1 pt
  14. The sharps container is below its fill line Yes / No 1 pt
  15. Nothing used for patient care is stored under the sink Yes / No 1 pt
  16. The employee asked could say where the emergency kit and the oxygen are kept Yes / No 1 pt
  17. Stocking of the operatories checked Rating
    • Complete and identical in every room 5 pts
    • Minor shortages or differences 3 pts
    • Items missing during care 1 pt

5. Equipment 19 items

  1. Compressed air and suction were available at the chairs before the first patient was seated Yes / No 1 pt
  2. The preset positions of the chair work Yes / No 1 pt
  3. The operating light switches on and stays where it is positioned Yes / No 1 pt
  4. The air/water syringe delivers air alone, water alone and spray Yes / No 1 pt
  5. High-volume suction pulls strongly at each operatory checked Yes / No 1 pt
  6. Coolant spray reaches the bur on each high-speed handpiece connection Yes / No 1 pt
  7. The fiber-optic light of the handpiece works Yes / No 1 pt
  8. The foot control runs the handpiece without sticking Yes / No 1 pt
  9. Curing light output is tested with a radiometer on the schedule set by company policy Yes / No 1 pt
  10. Curing light reading in the operatory checked (mW/cm2) Number
  11. The curing light tip is free of cured composite Yes / No 1 pt
  12. The ultrasonic scaler delivers water spray at the tip when activated Yes / No 1 pt
  13. The X-ray sensor is recognized by the imaging software on the operatory computer Yes / No 1 pt
  14. The intraoral camera displays a clear image Yes / No 1 pt
  15. The operatory computer is started with the imaging software open before the first patient Yes / No 1 pt
  16. The assistant call light or messaging system works from the operatory Yes / No 1 pt
  17. Equipment found faulty this week was reported on the fault log the same day Yes / No 1 pt
  18. Equipment out of service carries a tag Yes / No 1 pt
  19. Working order of chairside equipment at the start of the day Rating
    • Everything working 5 pts
    • Minor faults worked around 3 pts
    • A fault delaying patient care 1 pt

6. Waterlines 19 items

  1. Unit waterlines are flushed at the start of the day for the time set by company policy, with handpieces removed Yes / No 1 pt
  2. Self-contained water bottles are filled with the type of water set by company policy Yes / No 1 pt
  3. Bottles are handled with clean hands, without touching the pickup tube Yes / No 1 pt
  4. Bottles are emptied at the end of the day when the manufacturer requires it Yes / No 1 pt
  5. A continuous treatment product (tablet or cartridge) is in use on each unit Yes / No 1 pt
  6. Treatment cartridges are labeled with their installation date Yes / No 1 pt
  7. Treatment cartridges are within the service life stated by the manufacturer Yes / No 1 pt
  8. Shock treatment of the lines is done on the schedule set by company policy Yes / No 1 pt
  9. Date of the last shock treatment Date
  10. The water bottle cap and pickup tube are free of visible film or slime Yes / No 1 pt
  11. Each water bottle is marked with the number of its operatory Yes / No 1 pt
  12. The start-of-day flush is initialed for today on the waterline sheet of each unit Yes / No 1 pt
  13. The employee asked could state the flush time and the treatment product used on the unit Yes / No 1 pt
  14. No unit tagged out of use after a failed water test was used on a patient during the visit Yes / No 1 pt
  15. Sterile water or saline from a sterile delivery device is used for surgical procedures Yes / No 1 pt
  16. Units left unused beyond the period set by company policy are flushed before use Yes / No 1 pt
  17. Name of the lead dental assistant Short text
  18. Overall chairside readiness Rating
    • Strong 5 pts
    • Partial 3 pts
    • Weak 1 pt
  19. Corrective actions required Comments

About this template

This checklist is part of the Bindy template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In Bindy you can add photos, assign corrective actions, require sign-off and compare results across sites.

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