This infection control assessment checklist can be used for long-term care facilities such as nursing homes or assisted living facilities. Check the guidelines for infection control, immunization, hand hygiene, PPE, refrigerator monitoring, disinfection, laundry, kitchen, etc. Infection control templates can be customized to better fit the service offered by each healthcare facility.
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Are updated infection control guidelines revised and communicated to all?
Are copies of the manual available to team members in all units?
Has the infection control manual been revised annually in collaboration with the responsible committee?
Infection Program & Committee
Is there a separate agenda and minutes?
Is there a separate infection bulletin/scoreboard? Is the information up to date?
Is the inspection protocol drawn up at least annually?
Are trained respirator inspectors available?
Are all team members tested for infection knowledge at recruitment and every 2 years?
Are supplies (PPE, sanitizers, etc.) available for at least 3 days in case of an outbreak?
Is there a designated staff member who coordinates the infection prevention and control program and has training and experience in infection prevention and control: (a) Infectious disease (b) Cleaning and disinfection (c) Data collection
Are the names written on the personal belongings of each resident?- Personal hygiene items (toothbrushes, combs, etc.)- Nail clippers- Glucometer and eye drops
Do medications have expiration dates? i.e. injections, eye drops etc.
Check-ups & Vaccinations
Is the influenza vaccination strategy being followed?
Is the strategy of pneumonia and TdaP vaccination followed?
Are the guidelines for tuberculosis screening followed?
Are the guidelines for MRSA, AER and ESBL screening followed?
Is there a surveillance form in every residential area that is filled out correctly?
Are the data monitored and validated daily?
Are the infections monitored monthly?
Are the data analysed monthly?
Are the infection rates calculated?
Is the correct data collection sheet used?
Is the information collected on residents' infections at each shift analyzed daily to detect the presence of infections and reviewed at least monthly to identify trends in reducing the incidence of infections and outbreaks?
Are the surveillance data evaluated, analysed and presented at the meeting and is an action plan drawn up?
Is the number of residents with ARO in different units calculated on a monthly basis?
Is the procedure to confirm the outbreak followed?
Is the examination checklist followed?
Are the additional precautionary measures for the affected residents implemented immediately?
Is the outbreak management team activated?
Are the responsibilities of the department being followed?
Is the Outbreak Management Team meeting concluded with an action protocol?
Is there a folder where all relevant documents related to the outbreak are stored?
Are outbreak signs visible at each entrance?
Is a highly effective disinfectant used?
Hand Hygiene Program
Is there a structured hand hygiene program?- Hand hygiene test- Team member to support the residents in the implementation of hand hygiene before and after meals- Team members to support the residents in the implementation of hand hygiene before and after the activity- Calculation of hand hygiene rates, analysis of the data and development of an action plan if necessary- Communication of the rates with all team members- Appropriate nail and skin care- The following guidelines regarding jewellery
Are alcohol-based hand disinfectants available at the nursing station?
Is hand hygiene compliance monitored before and after the use of gloves?
Personal Protective Equipment (PPE)
Is the prescribed algorithm for putting on and taking off the PSA followed?
Is PPE available at the entrance to the resident's room as an additional precautionary measure?
Is there a sufficiently large waste bin in the immediate vicinity, accessible by a foot pedal, which is available to residents as an additional precautionary measure?
Is the medication refrigerator monitored and temperatures logged twice a day and actions are taken if they are out of range?
Is the vaccine refrigerator monitored and temperatures logged twice daily and actions are taken if out of range?
Is the sample refrigerator monitored and temperatures logged twice daily and actions are taken if out of range?
Are there annual training sessions in addition to the planned inspections? (influenza, outbreak, IPAC gaps, etc.)
Are providers and the competent authorities involved in the training?
Is the documentation of the training stored electronically or in paper form?
Sharp Disposable Products
Are the "dangerous" waste containers closed before overfilling?
Are the team members informed about the locations of hazardous waste?
Is an environmental audit carried out regularly?- Audit tools- Monitoring system- Evaluation and validation of data- Communication with team members
Are the steps for putting on and taking off the PPE correctly followed?
Is the correct use of gloves followed?
Dirty washrooms, clean washrooms, shower, bath room, laundry room- PSA availability- kept locked away from residents- spray head removed
Is there a problem with pest infestation? (cockroaches, ants, mice, etc.)
Are the rooms visually clean?- curtain for privacy- the room- the bathroom
Disinfection of Non-Critical Objects
Is the protocol for disinfecting non-critical items clear?- Nail clippers- Other
Is the responsibility for the disinfection of non-critical items clear between departments? (raised toilet seats, carbolization beds, lifting devices, etc.)
Is there a schedule, protocol or monitoring method/checklist?
Is the care community informed about the use of the highly effective disinfectant during the outbreak?
Are there educational events about the use of disinfectants?- Cleaning vs. disinfecting vs. disinfecting- Sanitation vs. disinfection at low level vs. disinfection at high level- dilution/titration, contact time/dwell time, mechanical action/friction- How to read the label
Is there a sporicidal cleaner that is immediately available on request?
Are the clean and dirty areas separated?
Is PPE available in the laundry?
Is there an alcohol-based disinfectant for the team members?
Other- Briefs separated from dirty cloths- Large manure is removed manually before it is sent to the laundry- Suitable wipes are used to clean the residents- Personal items removed from clothing before they are sent to the laundry- Dirty containers disinfected daily?
Are there cleaning protocols?
Are all temperatures (refrigerator, freezer, warming area, etc.) controlled and recorded?
Do the team members use appropriate aprons? (clothing is protected)
Is the previous report on the health care visit reviewed and followed up?
Activity and Programmes
Is there a care plan for pets?
Is there a schedule for cleaning equipment after the activity?
Are the team members offered training?
Are infection resources used?
Are PPE available to residents under additional precautions?
Are there signs available for residents for additional precautions?
Are there other areas that require attention?
Specify other areas
Did it meet the criteria?
Title, Name and Signature of Inspector
Please note that this checklist template is a hypothetical example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.
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