Infection Control Program Risk Assessment

2008

Program Probabili Risk/ (Health, Financial, Legal, Current

ty Impact Regulatory)
Score
Components System
Expect it Likely Maybe Rare Never Loss of Temp Prolonged Moderat Minimal s None Poor Fair Good Solid
life/limb loss of Length of e Clinical/
/ Function Stay Clinical/ Financial
function Financial
4 3 2 1 0 5 4 3 2 1 5 4 3 2 1
Failure of
Prevention
Activities
Lack of Hand
Hygiene
Lack of
Respiratory
Hygiene
Lack of Staff
Education
Lack of Patient
Education
Isolation
Activities
Lack of
Standard
Precautions/
PPE
Lack of Airborne
Precautions
Lack of Droplet
Precautions
Lack of Contact
Precautions
Failure to
use/lack of
negative
pressure room

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 Infection Control Program Risk Assessment
2008

Program Probabili Risk/ (Health, Financial, Legal, Current

ty Impact Regulatory)
Score
Components System
Expect it Likely Maybe Rare Never Loss of Temp Prolonged Moderat Minimal s None Poor Fair Good Solid
life/limb loss of Length of e Clinical/
/ Function Stay Clinical/ Financial
function Financial
4 3 2 1 0 5 4 3 2 1 5 4 3 2 1
Policy and
Procedure
Lack of current
policies or
procedures
Failure to follow
established
policy or
procedure
Exposure
Plans
Lack of B/BF
Exposure
Control Plan
Lack of
respiratory
protection plan
Risk of exposure
to TB
Lack of
Emergency
Preparedness
plan (exposure
to infectious
agents or
diseases)

Exposure to
SARS/Other
Respiratory
illness

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 Infection Control Program Risk Assessment
2008

Program Probabili Risk/ (Health, Financial, Legal, Current

ty Impact Regulatory)
Score
Components System
Expect it Likely Maybe Rare Never Loss of Temp Prolonged Moderat Minimal s None Poor Fair Good Solid
life/limb loss of Length of e Clinical/
/ Function Stay Clinical/ Financial
function Financial
4 3 2 1 0 5 4 3 2 1 5 4 3 2 1
Healthcare-
Associated
Infections
Surgical Site
Infections
Ventilator-
Associated
Pneumonia in
ICU
Central Line-
Associated
Bloodstream
Infections in
ICU

Catheter-
Associated
Urinary Tract
Infections- All
areas

Healthcare-
Associated
MRSA
Bacteremias- all
areas

Healthcare
Facility-
Associated
Clostridium
difficile-all areas

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 Infection Control Program Risk Assessment
2008

Program Probabili Risk/ (Health, Financial, Legal, Current

ty Impact Regulatory)
Score
Components System
Expect it Likely Maybe Rare Never Loss of Temp Prolonged Moderat Minimal s None Poor Fair Good Solid
life/limb loss of Length of e Clinical/
/ Function Stay Clinical/ Financial
function Financial
4 3 2 1 0 5 4 3 2 1 5 4 3 2 1
Outbreaks

Sentinel Event

Employee
Health
Lack of Staff
Immunization
Lack of
Compliance
with Annual
Health Review
Policy
Risk of
Needlestick/
Sharps Injury

Environment
Lack of
acceptable
environmental
cleanliness

Lack of
Hemodialysis
Monitoring

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 Infection Control Program Risk Assessment
2008

Program Probabili Risk/ (Health, Financial, Legal, Current

ty Impact Regulatory)
Score
Components System
Expect it Likely Maybe Rare Never Loss of Temp Prolonged Moderat Minimal s None Poor Fair Good Solid
life/limb loss of Length of e Clinical/
/ Function Stay Clinical/ Financial
function Financial
4 3 2 1 0 5 4 3 2 1 5 4 3 2 1
Lack of
Sterilization
Monitoring
Failure to
Identify
Construction
Risks
Antimicrobial
Stewardship
Lack of useful
antibiogram
Lack of
antimicrobial
use guidelines
Lack of
monitoring
program
Lack of
feedback
regarding
monitoring
results

Lack of
appropriate
vancomycin use
Lack of culture
to guide
antimicrobial
use

Other

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 Infection Control Program Risk Assessment
2008

Program Probabili Risk/ (Health, Financial, Legal, Current

ty Impact Regulatory)
Score
Components System
Expect it Likely Maybe Rare Never Loss of Temp Prolonged Moderat Minimal s None Poor Fair Good Solid
life/limb loss of Length of e Clinical/
/ Function Stay Clinical/ Financial
function Financial
4 3 2 1 0 5 4 3 2 1 5 4 3 2 1
Blood Culture
Contamination
Rates >2%
New Program
New
Procedure
Influenza
Immunization
Non-compliance
in patients
Pneumovax
Immunization
Non-compliance
in patients

The Infection Control (IC) Risk assessment grid is a visual tool to develop IC program priorities and stratify infection risks based on our

location in the community, our patient population and the review of our previous IC data analysis. The annual IC Plan is developed based on

these risks.

The IC Risk assessment is an ongoing, continual process. A more focused review is done on an annual basis after reviewing the quarterly

and annual reports with the Infection Control committee.

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 Infection Control Program Risk Assessment
2008

Program Probabili Risk/ (Health, Financial, Legal, Current

ty Impact Regulatory)
Score
Components System
Expect it Likely Maybe Rare Never Loss of Temp Prolonged Moderat Minimal s None Poor Fair Good Solid
life/limb loss of Length of e Clinical/
/ Function Stay Clinical/ Financial
function Financial
4 3 2 1 0 5 4 3 2 1 5 4 3 2 1

Approved by Infection Control Committee: ____________________________

Submitted by:

Form provided courtesy of Terrie Lee RN MS MPH CIC, Director, Epidemiology and Employee Health, Charleston Area Medical Center,
Charleston WV

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