Program Failure of Prevention Activities Hand Hygiene Respiratory Hygiene Staff Education Patient Education Basic Infection Prevention Standard Precautions/ PPE (Health,, Legal, safe pharmacy compounding practice high level disinfection practices Sterilization practices Failure to separate clean from dirty Page 1
Failure to safe injection practices (Health,, Legal, Page 2
Policy and Procedure current policies or procedures Failure to follow established policy or procedure (Health,, Legal, Exposure Plans B/BF Exposure Control Plan respiratory protection plan Risk of exposure to TB Emergency Preparedness plan (exposure to infectious agents or diseases) Healthcare- Associated Infections surveillance process Page 3
Outbreaks (Health,, Legal, Sentinel Events Employee Health Staff Immunization Compliance with Annual Health Review Policy Risk of Needlestick/ Sharps Injury Environment acceptable environmental cleanliness Sterilization Monitoring Failure to Identify Construction Risks Antimicrobial Stewardship Page 4
useful antibiogram antimicrobial use guidelines monitoring program (Health,, Legal, feedback regarding monitoring results appropriate surgical prophylaxis culture to guide antimicrobial use Other Influenza Immunization Noncompliance in patients The Infection Control (IC) Risk assessment grid is a visual tool to develop IC program priorities and stratify infection risks based on our Page 5
(Health,, Legal, location in the community, our patient population and the review of our previous IC data analysis. The annual IC Plan is developed based on these risks. The IC Risk assessment is an ongoing, continual process. A more focused review is done on an annual basis after reviewing the quarterly and annual reports with the Infection Control committee. Approved by Infection Control Committee: Submitted by: Form based on information provided by Terrie Lee RN MS MPH CIC, Director, Epidemiology and Employee Health, Charleston Area Medical Center, Charleston WV Page 6