Infection Control CheckList

Instructions: This checklist is meant to serve as a general guideline for our client facilities as to the level of your skills within your nursing specialty. Please use the scale below to describe your experience/expertise in each area listed below.

Proficiency Scale:

1 = No Experience

2 = Need Training

3 = Able to perform with supervision

4 = Able to perform independently

Surveillance Rating Stars (Click) 1 2 3 4  
 Performs targeted surveillance 
Outbreak investigations 
Collaboration  with Infection Control Committee 
Collaboration with Hospital Epidemiologist 
Performance improvement projects related in communicable diseases 
Collects, monitors, and maintains data using  facility HER 
Utilize Center for Disease Control (CDC) 
Infection criteria 
Documentation and investigation techniques 
Rounds of hospital units 
Case definition, and other related patient care issues 
Monitor  infection control practices 
Nosocomial infections  or AHIs, MRSAs 
Health care workers exposures 
Tracing the possible sources of infection or transmission of microorganisms 
Identification of Problems Rating Stars (Click) 1 2 3 4  
Regularly meet with the hospital Epidemiologist 
Risk  reduction among patients, facility staff, volunteers, students, and visitors 
Understand the transmission and break of infections 
Identification of epidemiologically important issues for Infection Control Committee 
Hospital Epidemiologist, and Administration Rating Stars (Click) 1 2 3 4  
Design COA  including Surveillance, Outbreak Investigations, and Performance Improvement Projects 
Communicable diseases reporting as required by the state and the local health authority 
Compliance with federal and state laws regarding  medical wastes, chemicals in the workplace, infectious disease exposures 
OSHA NIOSH standards 
Blood borne pathogens and respiratory pathogens 
Chart review 
Policies and Procedures Rating Stars (Click) 1 2 3 4  
Infection Control policies associated with infection 
Staff practices associated with infection contol 
Professional guidelines (CDC, APIC, etc.) 
The Joint Commission guidelines on infection Control 
Infection Control Plan to reflect and meet any required changes 
Coordination Rating Stars (Click) 1 2 3 4  
Acts as department liaison for Infection Control Department 
Act as consultant for the facility Infection Control activities 
Interdepartment and personnel coordination on risk  reduction, transmission and improved infection control practices 
Provide coordinated services to patients for the improvement of overall 
Patient care 
Education Rating Stars (Click) 1 2 3 4  
In-services of all and current employees  on Infection Control 
Orientation programs of new employees on Infection Control 
Infection Control techniques and Policies and Procedures 
Age Specific Competencies Rating Stars (Click) 1 2 3 4  
Infant (Birth - 1 year) 
Preschooler (ages 2-5 years) 
Childhood (ages 6-12 years) 
Adolescents (ages 13-21 years) 
Young Adults (ages 22-39 years) 
Adults (ages 40-64 years) 
Older Adults (ages 65-79 years) 
Elderly (ages 80+ years)