Infection control assessment and response (ICAR) tools were developed by the CDC under the Epidemiology and Laboratory Capacity (ELC) Cooperative Agreement to assist health departments in assessing infection prevention practices and guide quality improvement activities. These tools may also be used by healthcare facilities to conduct internal quality improvement audits. ICAR tools are used to assess a facility’s infection prevention and control practices. The assessments are not regulatory and are designed to identify a facility’s strengths and areas for improvement in infection prevention and control. For more information, please check here.
Proactive assessments, completed when a facility is not currently experiencing an outbreak, can be conducted onsite at the facility. The VDH HAI/AR Program recommends conducting a reactive visit in certain circumstances like infection control breach or outbreak investigation in healthcare settings. Reactive assessments may include COVID-19 ICARs. COVID-19 ICARs in long-term care facilities and outpatient dialysis facilities can be conducted onsite or virtually (teleICARs) in certain circumstances. For questions regarding reactive ICARs and/or teleICARs, please contact firstname.lastname@example.org.
Proactive Onsite Infection Prevention & Control Assessments with VDH
ICAR Enrollment Process
- Request an assessment. If you would like to request an ICAR for more than one type of setting, please complete a request form for each setting. You will also need to enter facility demographic information such as facility type, number of licensed beds, and number of infection preventionist full-time equivalents.
- Complete a self-assessment. Select the assessment tool that is specific to your setting.
- Acute Care: CDC Infection Prevention and Control Assessment Tool for Acute Care Hospitals
- Long-Term Care: CDC Infection Prevention and Control Assessment Tool for Long-term Care Facilities
- Outpatient Settings (Non-dialysis): CDC Infection Prevention and Control Assessment Tool for Outpatient Settings
- Dialysis Settings: CDC Infection Prevention and Control Assessment Tool for Dialysis settings.
- An ICAR team member will contact you by phone or email to schedule a site visit.
- Determine what staff (e.g. leadership, nursing, environmental services, etc.) you would like to participate in the visit.
- Identify a meeting or conference room at your facility to hold the visit.
- Participate in the visit. The visit is non-regulatory with the intent to establish a relationship for continued partnership. During the visit, ICAR staff will help to identify facility priorities and challenges to tailor references for each facility.
- Together with the ICAR staff, select a priority on which to focus your efforts.
- An ICAR team member summarizes the assessment results and conversation in a report that includes resources to address identified focus areas. The report will include the ICAR visit summary and recommendations, in addition to the VDH Infection Prevention and Control Scoring Report. Please check the Definitions section (below) for more information on the scoring report.
- Implement ICAR suggestions, tools, and identified resources as you are able and at your own pace.
- Complete a short survey sent by the ICAR team to collect progress six months after the site visit. The survey will ask about the improvement plan, how the plan will be implemented (e.g., steps, timeline, responsible party, etc.), current progress, and any identified barriers. If necessary, a follow-up visit from the ICAR team can be conducted to assess progress on implementing recommendations and to provide additional resources and support.
The following definitions have been developed to assist with the implementation of elements of the CDC ICAR assessment tools related to infection prevention competency, training, auditing and feedback.
- VDH Infection Prevention and Control Scoring Report: The ICAR scoring report was developed by the HAI/AR Program at VDH. It provides a quantitative measure for each infection control domain, summarizing both strengths and opportunities for improvement.
- The scoring tool can be used to:
- Report back to facility administration in a simple, user-friendly format
- Prioritize follow-up actions for areas in need of improvement
- Compile and analyze scores in a systematized way statewide to identify and address major defects under each infection control domain.
- The scoring tool can be used to:
- Healthcare Personnel Infection Prevention (IP) Competency: The proven ability to apply essential knowledge, skills, and abilities to prevent the transmission of pathogens during the provision of care.
- Healthcare Personnel IP Competency-Based Training: The provision of job-specific education, training, and assessment to ensure that healthcare personnel possess IP competency.
- Competency Assessment: The verification of IP competency through the use of knowledge-based testing and direct observation. If direct observation is not included as part of a competency assessment, an alternative method to ensure that healthcare personnel possess essential knowledge, skills, and abilities should be used.
- Audit: Direct observation or monitoring of healthcare personnel adherence to job-specific IP measures.
- Feedback: A summary of audit findings that is used to target performance improvement.
- Direct Observation of Facility Practices: Observation of infection prevention practices during onsite ICAR visits like hand hygiene, PPE donning and doffing, environmental cleaning, wound care and point of care testing. If an element is unable to be observed during an assessment (e.g., no patients received point-of-care testing during the visit), assessment of the element might be completed by interviewing appropriate personnel about facility practices.