Infection Prevention & Control Policies & Forms
(also see IP&C Guidelines)
| Policy # | Title | Rationale | Date | Summary | Link |
|---|---|---|---|---|---|
| IC-AC/LTC 6.8 | Management of Antibiotic Resistant Organisms AROs ARCHIVE NOTICE | Feb 16, 2026 | |||
| CLI.8011.PL.011.FORM.01 | Post Exposure Protocol Follow Up Checklist | Providing clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access. | Dec 22, 2025 | ||
| CLI.8011.PL.011 | Post Exposure to Blood and Body Fluids | Providing clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access. | Dec 22, 2025 | ||
| CLI.8011.PL.011.SD.01 | Post Exposure Protocol Quick Reference Guide | Providing clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access. | Dec 22, 2025 | ||
| CLI.8011.PL.011.FORM.02 | PEP Needlestick injuries BBF Exposure Line List | Providing clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access. | Dec 22, 2025 | ||
| CLI.8011.PL.011.SD.02 | Template Letter to Exposed Healthcare Provider | Providing clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access. | Dec 22, 2025 | ||
| CLI.8011.PL.011.FORM.02 | PEP Needlestick injuries BBF Exposure Line List | Providing clarification to Regional Centre ICPs in management of occupational exposures to blood and body fluids: including template letter to Exposed's Health Care Provider, expanded PEP Needlestick Injuries BBF Exposure Line List with information required to be source of truth and identifying a secure drive to store all post-exposure related documents as recommended by Regional Officer - Privacy and Access. | Dec 22, 2025 | ||
| CLI.8011.PL.024.SD.01 | Message to Accompany Annual Resident Consent | Aug 18, 2025 | |||
| CLI.8011.PL.024.SD.01.F | Message to Accompany Annual Resident Consent French | Aug 18, 2025 | |||
| CLI.8011.PL.008.FORM.07 | Staff Immunization Vaccine and Tuberculin Order | Jul 7, 2025 | |||
| CLI.8011.PL.008.FORM.01 | Confidential Employee Immunization Form | Jul 7, 2025 | |||
| CLI.8011.PL.008.SD.02 | Occupational Safety and Health Standard Orders | Jul 7, 2025 | |||
| CLI.8011.PL.008.FORM.02 | Occupational Health Immunization Intake Form | Jul 7, 2025 | |||
| CLI.8011.PL.008 | Occupational Health Immunizations for Health Care Workers | Jul 7, 2025 | |||
| CLI.8011.PL.008.FORM.03 | Occupational Health Immunization Review Summary Form | Jul 7, 2025 | |||
| CLI.8011.PL.008.FORM.04 | Occupational Safety and Health Employee Immunization Referral Form | Jul 7, 2025 | |||
| CLI.8011.PL.008.FORM.06 | Positive Tuberculin Skin Test TST Physician Referral Form | Jul 7, 2025 | |||
| CLI.8011.PL.008.FORM.08 | Occupational Health Employee Intake Form | Jul 7, 2025 | |||
| CLI.8011.PL.024 | Respiratory Virus Season Planning and Response in Personal Care Homes | Mar 3, 2025 | |||
| CLI.8011.PL.024.FORM.01 | COVID 19 Influenza Pneumococcal and RSV Immunization Consent Form | Mar 3, 2025 | |||
| CLI.8011.PL.024.FORM.01.F | COVID 19 Influenza Pneumococcal and RSV Immunization Consent Form French | Mar 3, 2025 | |||
| CLI.8011.SG.004 | Occupational Health Infectious Disease and Upper Extremity Supportive Device Work Restrictions | Feb 10, 2025 | |||
| CLI.8011.SG.004.SD.01 | Illness Restrictions Precaution Table | Feb 10, 2025 | |||
| CLI.8011.PL.004.FORM.02 | Outbreak Report | Feb 7, 2025 | |||
| CLI.8011.PL.023 | Respiratory Virus Season Planning and Response in Acute Care | IP&C has amalgamated 2 policies to provide clear direction for Acute Care. | Nov 1, 2024 | ||
| CLI.8011.PL.004.FORM.01 | Outbreak Line List | Updated policy and documents to provide clear direction for Acute Care and Personal Care Homes. Community outbreaks no longer included in this policy | Nov 1, 2024 | ||
| CLI.8011.PL.004 | Outbreak Management Respiratory including Influenza and COVID 19 and Gastrointestinal | Updated policy and documents to provide clear direction for Acute Care and Personal Care Homes. Community outbreaks no longer included in this policy | Nov 1, 2024 | ||
| CLI.8011.FORM.002 | Chickenpox Shingles Screening Checklist | tool was designed to provide explanation to staff and give the knowledge required to provide safe patient care and ensure safe practices to staff | Oct 9, 2024 | ||
| CLI.8011.PL.022.SD.01 | Methicillin Resistent Staphylococcus aureus MRSA Fact Sheet | Harmonizing policies to provide direction to SH-SS staff in caring for ARO positive/suspect clients across all care areas. | Aug 1, 2024 | ||
| CLI.8011.PL.022.SD.01.F | Methicillin Resistent Staphylococcus aureus MRSA Fact Sheet French | Harmonizing policies to provide direction to SH-SS staff in caring for ARO positive/suspect clients across all care areas. | Aug 1, 2024 | ||
| CLI.8011.PL.022.SD.02 | Carbapenemase Producing Enterobacteriaceae CPE Fact Sheet | Harmonizing policy from other regions. To provide direction to SH-SS staff in caring for ARO positive/suspect clients across all care areas. | Aug 1, 2024 | ||
| CLI.8011.PL.022.SD.02.F | Carbapenemase Producing Enterobacteriaceae CPE Fact Sheet French | Harmonizing policy. To provide direction from SH-SS staff in caring for ARO positive/suspect clients across all care areas. | Aug 1, 2024 | ||
| CLI.8011.PL.022 | Management of Antimicrobial Resistant Organisms AROs | Harmonizing policy. To provide direction for SH-SS staff in caring for ARO positive/suspect clients across all care areas. | Aug 1, 2024 | ||
| Wound Consult Form | Jul 18, 2024 | ||||
| CLI.8011.PL.018.FORM.02 | Healthcare Associated Infection Surveillance Forms – Personal Care Homes | Definitions for healthcare associated infection has been revised | Jul 3, 2024 | ||
| CLI.8011.PL.018.FORM.01 | Healthcare Associated Infection Surveillance Form – Acute Care | Definition for healthcare associated infections have been revised. | Jul 3, 2024 | ||
| CLI.8011.PL.018 | Surveillance of Healthcare Associated Infections in Acute Care and Personal Care Homes | Definitions for healthcare associated infections have been revised. Policy now reflects the inclusion and roles of the Regional LTC IP&C Nurse and Infection Control Support Associates. | Jul 3, 2024 | ||
| CLI.8011.PL.002.FORM.01 | Antibiotic Resistent Organisms Admission Screening | Mar 13, 2024 | |||
| CLI.8011.PL.002.SD.01 | Antibiotic Resistant Organism Flagging Codes and Required Actions | Mar 13, 2024 | |||
| CLI.8011.PL.002 | Admission Screening for Antibiotic Resistent Organisms AROs | Mar 13, 2024 | |||
| CLI.8011.PL.021.SD.01.F | Additional precautions poster – French | May 5, 2023 | |||
| CLI.8011.PL.021.SD.01 | Additional Precautions poster | May 5, 2023 | |||
| CLI.8011.PL.021 | Additional Precautions Policy | May 5, 2023 | |||
| CLI.8011.PL.017 | Clostridioides Difficile Infection CDI Management | Apr 24, 2023 | |||
| CLI.8011.PL.020.SD.02.F | Donning PPE poster – French | Feb 14, 2023 | |||
| CLI.8011.PL.020.SD.02 | Donning PPE poster | Feb 14, 2023 | |||
| CLI.8011.PL.020.SD.03.F | Doffing PPE poster – French | Feb 14, 2023 | |||
| CLI.8011.PL.020.SD.03 | Doffing PPE poster | Feb 14, 2023 | |||
| CLI.8011.PL.020 | Routine Practices | Feb 14, 2023 | |||
| CLI.8011.PL.020.SD.01 | Point of Care Risk Assessment PCRA | Feb 14, 2023 | |||
| CLI.8011.PL.007.FORM.01 | Oseltamivir Dosage Calculation Chart | Feb 13, 2023 | |||
| CLI.8011.PL.019.FORM.04 | Memorandum for Surgeons | Jan 16, 2023 | |||
| CLI.8011.PL.019 | Surgical Site Infection SSI Surveillance | Jan 16, 2023 | |||
| CLI.8011.PL.019.SD.01 | Surgical Wound Classification Table | Jan 16, 2023 | |||
| CLI.8011.PL.019.FORM.01 | Surgical Site Infection Report Form | Jan 16, 2023 | |||
| CLI.8011.PL.019.FORM.02 | Surgical Site Infection Data Collection Form | Jan 16, 2023 | |||
| CLI.8011.PL.019.SD.02 | Patient Fact Sheet Preventing Surgical Site Infections | Jan 16, 2023 | |||
| CLI.8011.PL.019.SD.02.F | Patient Fact Sheet Preventing Surgical Site Infections – French | Jan 16, 2023 | |||
| CLI.8011.PL.019.FORM.03 | Postoperative SSI Surveillance Telephone Script | Jan 16, 2023 | |||
| CLI.8011.PL.001.SD.07 | Infection Prevention and Control Hand Hygiene Poster Placement Guidelines | May 5, 2022 | |||
| CLI.8011.PL.001.FORM.02 | 4 Moments for Hand Hygiene Audit and 4 Moments for Hand Hygiene Audit Form Instructions for Use – Facility | May 5, 2022 | |||
| CLI.8011.PL.001.FORM.01 | 4 Moments for Hand Hygiene Audit and 4 Moments for Hand Hygiene Audit Form Instructions for Use – Community | May 5, 2022 | |||
| CLI.8011.PL.017.SD.01.F | Client Fact Sheet – Clostridioides Difficile – French | May 5, 2022 | |||
| CLI.8011.PL.017.SD.01 | Client Fact Sheet – Clostridioides difficile | May 5, 2022 | |||
| CLI.8011.PL.001 | Hand Hygiene | May 5, 2022 | |||
| CLI.8011.PL.001.SD.05 | Hand Hygiene Considerations in Facility Design | May 5, 2022 | |||
| CLI.8011.PL.001.SD.06 | General Hand Care Instructions Staff Handout | May 5, 2022 | |||
| CLI.8011.PL.001.SD.02 | SH SS Hand Hygiene How To Hand Rub and How to Hand Wash – Bilingual Posters | May 5, 2022 | |||
| CLI.8011.PL.001.SD.08 | Visitors – Stop the Spread of Infections Poster | May 5, 2022 | |||
| CLI.8011.FORM.001 | Tuberculin Skin Testing Fact Sheet | Oct 27, 2021 | |||
| CLI.8011.PL.008.SD.01 | Tuberculin Skin Test TST Referral Guideline | Oct 27, 2021 | |||
| CLI.8011.PL.008.FORM.05 | Occupational Safety and Health Employee TST Referral Form | Oct 27, 2021 | |||
| CLI.8011.PR.001 | Personal Protective Equipment PPE Observer Procedure | May 3, 2021 | |||
| CLI.8011.PR.001.FORM.01 | Personal Protective Equipment PPE Observation Log | May 3, 2021 | |||
| CLI.8011.PR.001.SD.01 | Personal Protective Equipment PPE Donning and Doffing Observation Guide | May 3, 2021 | |||
| CLI.8011.PL.013 | Pneumococcal Vaccine Administration to Residents in Personal Care Homes | Oct 5, 2020 | |||
| CLI.8011.SG.005 | Portable Fan Usage in Healthcare Facilities | Jul 23, 2020 | |||
| CLI.8011.PL.014 | Bed Bug Management in Acute Care and Personal Care Home | May 19, 2020 | |||
| CLI.8011.PL.015 | Reporting of Infectious Diseases and Conditions by HCPs in AC and PCH | Jan 7, 2020 | |||
| CLI.8011.SG.001.SD.02 | Urine Trouble Bilingual | Dec 17, 2019 | |||
| CLI.8011.SG.001 | Standard Guideline Diagnosis and Management of Urinary Tract Infections in Long Term Care | Sep 9, 2019 | |||
| CLI.8011.SG.001.SD.01 | Urinary Tract Infection – Clinical Care Map | Sep 9, 2019 | |||
| CLI.8011.PL.010.FORM.02 | Infection Control Site Monitoring Tool | Feb 4, 2019 | |||
| CLI.8011.PL.010.FORM.01 | Infection Control Risk Assessment ICRA for Health Care Facility | Feb 4, 2019 | |||
| CLI.8011.PL.010.SD.02 | Infection Control Preventive Measures Plan | Feb 4, 2019 | |||
| CLI.8011.PL.010.FORM.03 | Infection Control Post Construction Checklist | Feb 4, 2019 | |||
| CLI.8011.PL.010.SD.03.F | Infection Control Construction Barrier Sign French | Feb 4, 2019 | |||
| CLI.8011.PL.010.SD.03 | Infection Control Construction Barrier Sign English | Feb 4, 2019 | |||
| CLI.8011.PL.010 | Infection Prevention During Construction Renovation and Maintenance | Feb 4, 2019 | |||
| CLI.8011.PL.010.FORM.04 | Construction Air Handling Inspection Sheet | Feb 4, 2019 | |||
| CLI.8011.PL.010.FORM.05 | Pressure Differential Daily Checklist | Feb 4, 2019 | |||
| CLI.8011.PL.010.SD.01 | Preventive Measures Quick Reference List | Feb 4, 2019 | |||
| CLI.8011.PL.005 | Single Use Medical Devices | Aug 2, 2018 | |||
| CLI.8011.PL.006.FORM.01 | Facility Owned Pet Assessment Checklist | Aug 18, 2017 | |||
| CLI.8011.PL.006.FORM.02 | Facility Owned Pet Veterinary Record Form | Aug 18, 2017 | |||
| CLI.8011.PL.006.FORM.03 | Facility Owned Pet Care Record | Aug 18, 2017 | |||
| CLI.8011.PL.006 | Pet Visitation in Health Care | Aug 18, 2017 | |||
| CLI.8011.SG.003 | Guidelines for Selection and Management of Isolation Carts | Aug 8, 2017 | |||
| IPC-E00.013 | Scabies Flow Sheet for Follow Up | May 2, 2017 | |||
| CLI.8011.SG.002 | Bed Bug Management in Community Care | Jan 9, 2017 | |||
| CLI.8011.PL.003 | Administration of Tuberculin Skin Test | Jun 16, 2016 | |||
| CLI.8011.PL.001.SD.01.F | 4 Moments for Hand Hygiene When Why Poster – French | Oct 20, 2014 | |||
| CLI.8011.PL.001.SD.01 | 4 Moments for Hand Hygiene When Why Poster | Oct 20, 2014 | |||
| CLI.8011.PL.001.SD.04 | 4 Moments for Hand Hygiene Information for Clients Visitors Families and Volunteers Poster | Oct 14, 2014 | |||
| CLI.8011.PL.001.SD.04.F | 4 Moments for Hand Hygiene Information for Clients Visitors Families and Volunteers Poster – French | Oct 14, 2014 | |||
| CLI.8011.PL.001.SD.03 | 4 Moments for Hand Hygiene Picture Poster | Dec 6, 2013 | |||
| MDR-5.1 | Point of use Unit Manual Cleaning and Disinfection of Instruments Equipment | Jun 18, 2012 | |||
| IPC-101.000 | Foot Care Infection Control | May 31, 2012 | |||
| IPC-E00.080 | Testing For Methicillin Resistant Staphylococcus Aureus Factsheet For Client And Family Acute Care | Mar 28, 2012 | |||
| IC-AC-6.7 | Management of Scabies | Feb 10, 2012 | |||
| IPC-126.000 | Cleaning And Disinfection Of Non Critical Reusable Client Care Equipment In Facilities | Dec 8, 2010 | |||
| IPC-E00.100 | Equipment Cleaning Schedule | Oct 22, 2010 | |||
| IPC-E00.098 | Minimum Cleaning and Disinfection of Equipment | Oct 22, 2010 | |||
| IPC-E00.052 | Scabies Case Worksheet Client | Aug 27, 2010 | |||
| IPC-E00.096 | Scabies Body Diagram For Rash Documentation | Aug 27, 2010 | |||
| IPC.109.000 | Scabies | Aug 27, 2010 | |||
| IPC-1100.007 | Healthcare Assoicated Urinary Tract Infection in Acute Care | Apr 1, 2008 | |||
| IPC-1100.019 | Healthcare Associated Urinary Tract Infections in Long Term Care | Apr 1, 2008 | |||
| IPC-E00.056 | Scabies Outbreak Staff Notice | Apr 1, 2008 | |||
| IPC-E00.058 | Scabies Outbreak Admission Precaution | Apr 1, 2008 | |||
| IPC-E00.012 | Scabies Line Lists for Treatment Categories | Apr 1, 2008 | |||
| IPC-E00.059 | Scabies Instruction for Nix Treatment | Apr 1, 2008 | |||
| IPC-E00.054 | Scabies Employee With Scabies for Occupational Safety and Health Program | Apr 1, 2008 | |||
| IPC-E00.053 | Scabies Contact Tracing Worksheet | Apr 1, 2008 | |||
| IPC-E00.014 | Scabies Client Teaching Sheet | Apr 1, 2008 | |||
| IPC-E00.055 | Scabies Procedure for Skin Scraping | Apr 1, 2008 | |||
| IPC-E00.057 | Scabies Outbreak Visitor Notice | Apr 1, 2008 |