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IP&C Guidelines | Policies & Forms

(also see Infection Prevention & Control)

Policy #TitleRationaleDateSummaryLink
CLI.8011.PL.011.FORM.01Post Exposure Protocol Follow Up ChecklistProviding 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.011Post Exposure to Blood and Body FluidsProviding 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.02PEP Needlestick injuries BBF Exposure Line ListProviding 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.01Post Exposure Protocol Quick Reference GuideProviding 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.02Template Letter to Exposed Healthcare ProviderProviding 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.02PEP Needlestick injuries BBF Exposure Line ListProviding 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.008.FORM.01Confidential Employee Immunization FormJul 7, 2025
CLI.8011.PL.008.FORM.07Staff Immunization Vaccine and Tuberculin OrderJul 7, 2025
CLI.8011.PL.008.SD.02Occupational Safety and Health Standard OrdersJul 7, 2025
CLI.8011.PL.008.FORM.02Occupational Health Immunization Intake FormJul 7, 2025
CLI.8011.PL.008Occupational Health Immunizations for Health Care WorkersJul 7, 2025
CLI.8011.PL.008.FORM.03Occupational Health Immunization Review Summary FormJul 7, 2025
CLI.8011.PL.008.FORM.04Occupational Safety and Health Employee Immunization Referral FormJul 7, 2025
CLI.8011.PL.008.FORM.06Positive Tuberculin Skin Test TST Physician Referral FormJul 7, 2025
CLI.8011.SG.004Occupational Health Infectious Disease and Upper Extremity Supportive Device Work RestrictionsFeb 10, 2025
CLI.8011.SG.004.SD.01Illness Restrictions Precaution TableFeb 10, 2025
CLI.8011.PL.004.FORM.02Outbreak ReportFeb 7, 2025
CLI.8011.PL.023Respiratory Virus Season Planning and Response in Acute CareIP&C has amalgamated 2 policies to provide clear direction for Acute Care.Nov 1, 2024
CLI.8011.PL.004.FORM.01Outbreak Line ListUpdated policy and documents to provide clear direction for Acute Care and Personal Care Homes. Community outbreaks no longer included in this policyNov 1, 2024
CLI.8011.PL.004Outbreak Management Respiratory including Influenza and COVID 19 and GastrointestinalUpdated policy and documents to provide clear direction for Acute Care and Personal Care Homes. Community outbreaks no longer included in this policyNov 1, 2024
CLI.8011.FORM.002Chickenpox Shingles Screening Checklisttool was designed to provide explanation to staff and give the knowledge required to provide safe patient care and ensure safe practices to staffOct 9, 2024
CLI.8011.PL.018.FORM.02Healthcare Associated Infection Surveillance Forms – Personal Care HomesDefinitions for healthcare associated infection has been revisedJul 3, 2024
CLI.8011.PL.018.FORM.01Healthcare Associated Infection Surveillance Form – Acute CareDefinition for healthcare associated infections have been revised.Jul 3, 2024
CLI.8011.PL.018Surveillance of Healthcare Associated Infections in Acute Care and Personal Care HomesDefinitions 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.SD.01Antibiotic Resistant Organism Flagging Codes and Required ActionsMar 13, 2024
CLI.8011.PL.002Admission Screening for Antibiotic Resistent Organisms AROsMar 13, 2024
CLI.8011.PL.002.FORM.01Antibiotic Resistent Organisms Admission ScreeningMar 13, 2024
CLI.8011.PL.021Additional Precautions PolicyMay 5, 2023
CLI.8011.PL.021.SD.01.FAdditional precautions poster – FrenchMay 5, 2023
CLI.8011.PL.021.SD.01Additional Precautions posterMay 5, 2023
CLI.8011.PL.017Clostridioides Difficile Infection CDI ManagementApr 24, 2023
CLI.8011.PL.020.SD.02Donning PPE posterFeb 14, 2023
CLI.8011.PL.020.SD.02.FDonning PPE poster – FrenchFeb 14, 2023
CLI.8011.PL.020.SD.03.FDoffing PPE poster – FrenchFeb 14, 2023
CLI.8011.PL.020.SD.03Doffing PPE posterFeb 14, 2023
CLI.8011.PL.020Routine PracticesFeb 14, 2023
CLI.8011.PL.020.SD.01Point of Care Risk Assessment PCRAFeb 14, 2023
CLI.8011.PL.007.FORM.01Oseltamivir Dosage Calculation ChartFeb 13, 2023
CLI.8011.PL.019.FORM.04Memorandum for SurgeonsJan 16, 2023
CLI.8011.PL.019Surgical Site Infection SSI SurveillanceJan 16, 2023
CLI.8011.PL.019.FORM.02Surgical Site Infection Data Collection FormJan 16, 2023
CLI.8011.PL.019.SD.01Surgical Wound Classification TableJan 16, 2023
CLI.8011.PL.019.FORM.01Surgical Site Infection Report FormJan 16, 2023
CLI.8011.PL.019.SD.02.FPatient Fact Sheet Preventing Surgical Site Infections – FrenchJan 16, 2023
CLI.8011.PL.019.SD.02Patient Fact Sheet Preventing Surgical Site InfectionsJan 16, 2023
CLI.8011.PL.019.FORM.03Postoperative SSI Surveillance Telephone ScriptJan 16, 2023
CLI.8011.PL.001.SD.07Infection Prevention and Control Hand Hygiene Poster Placement GuidelinesMay 5, 2022
CLI.8011.PL.001.FORM.014 Moments for Hand Hygiene Audit and 4 Moments for Hand Hygiene Audit Form Instructions for Use – CommunityMay 5, 2022
CLI.8011.PL.001.FORM.024 Moments for Hand Hygiene Audit and 4 Moments for Hand Hygiene Audit Form Instructions for Use – FacilityMay 5, 2022
CLI.8011.PL.017.SD.01.FClient Fact Sheet – Clostridioides Difficile – FrenchMay 5, 2022
CLI.8011.PL.017.SD.01Client Fact Sheet – Clostridioides difficileMay 5, 2022
CLI.8011.PL.001.SD.05Hand Hygiene Considerations in Facility DesignMay 5, 2022
CLI.8011.PL.001Hand HygieneMay 5, 2022
CLI.8011.PL.001.SD.06General Hand Care Instructions Staff HandoutMay 5, 2022
CLI.8011.PL.001.SD.02SH SS Hand Hygiene How To Hand Rub and How to Hand Wash – Bilingual PostersMay 5, 2022
CLI.8011.PL.001.SD.08Visitors – Stop the Spread of Infections PosterMay 5, 2022
CLI.8011.PL.008.SD.01Tuberculin Skin Test TST Referral GuidelineOct 27, 2021
CLI.8011.FORM.001Tuberculin Skin Testing Fact SheetOct 27, 2021
CLI.8011.PL.008.FORM.05Occupational Safety and Health Employee TST Referral FormOct 27, 2021
CLI.8011.PR.001.FORM.01Personal Protective Equipment PPE Observation LogMay 3, 2021
CLI.8011.PR.001Personal Protective Equipment PPE Observer ProcedureMay 3, 2021
CLI.8011.PR.001.SD.01Personal Protective Equipment PPE Donning and Doffing Observation GuideMay 3, 2021
CLI.8011.PL.013Pneumococcal Vaccine Administration to Residents in Personal Care HomesOct 5, 2020
CLI.8011.SG.005Portable Fan Usage in Healthcare FacilitiesJul 23, 2020
CLI.8011.PL.014Bed Bug Management in Acute Care and Personal Care HomeMay 19, 2020
CLI.8011.PL.015Reporting of Infectious Diseases and Conditions by HCPs in AC and PCHJan 7, 2020
CLI.8011.SG.001.SD.02Urine Trouble BilingualDec 17, 2019
CLI.8011.SG.001Standard Guideline Diagnosis and Management of Urinary Tract Infections in Long Term CareSep 9, 2019
CLI.8011.SG.001.SD.01Urinary Tract Infection – Clinical Care MapSep 9, 2019
CLI.8011.PL.010.FORM.01Infection Control Risk Assessment ICRA for Health Care FacilityFeb 4, 2019
CLI.8011.PL.010.FORM.02Infection Control Site Monitoring ToolFeb 4, 2019
CLI.8011.PL.010.SD.02Infection Control Preventive Measures PlanFeb 4, 2019
CLI.8011.PL.010.FORM.03Infection Control Post Construction ChecklistFeb 4, 2019
CLI.8011.PL.010.SD.03.FInfection Control Construction Barrier Sign FrenchFeb 4, 2019
CLI.8011.PL.010.SD.03Infection Control Construction Barrier Sign EnglishFeb 4, 2019
CLI.8011.PL.010Infection Prevention During Construction Renovation and MaintenanceFeb 4, 2019
CLI.8011.PL.010.FORM.04Construction Air Handling Inspection SheetFeb 4, 2019
CLI.8011.PL.010.FORM.05Pressure Differential Daily ChecklistFeb 4, 2019
CLI.8011.PL.010.SD.01Preventive Measures Quick Reference ListFeb 4, 2019
CLI.8011.PL.005Single Use Medical DevicesAug 2, 2018
CLI.8011.PL.006.FORM.01Facility Owned Pet Assessment ChecklistAug 18, 2017
CLI.8011.PL.006.FORM.03Facility Owned Pet Care RecordAug 18, 2017
CLI.8011.PL.006.FORM.02Facility Owned Pet Veterinary Record FormAug 18, 2017
CLI.8011.PL.006Pet Visitation in Health CareAug 18, 2017
CLI.8011.SG.003Guidelines for Selection and Management of Isolation CartsAug 8, 2017
CLI.8011.SG.002Bed Bug Management in Community CareJan 9, 2017
CLI.8011.PL.003Administration of Tuberculin Skin TestJun 16, 2016
CLI.8011.PL.001.SD.01.F4 Moments for Hand Hygiene When Why Poster – FrenchOct 20, 2014
CLI.8011.PL.001.SD.014 Moments for Hand Hygiene When Why PosterOct 20, 2014
CLI.8011.PL.001.SD.04.F4 Moments for Hand Hygiene Information for Clients Visitors Families and Volunteers Poster – FrenchOct 14, 2014
CLI.8011.PL.001.SD.044 Moments for Hand Hygiene Information for Clients Visitors Families and Volunteers PosterOct 14, 2014
CLI.8011.PL.001.SD.034 Moments for Hand Hygiene Picture PosterDec 6, 2013

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