October 2020 Version 2.0 Infection Prevention and Control (IPAC) Toolkit Purpose The purpose of the toolkit is to support a consistent Infection Prevention and Control (IPAC) approach across the Ontario West region, with a focus on COVID-19 response by providing validated and credible resources, based on science, evidence and best practice to build capacity at the local, organization and individual level. The toolkit consists of 3 parts: resources, IPAC COVID-19 response process, and a frequently asked questions (FAQ) page including “what is the difference between Public health units and public health Ontario. Note: Information is changing rapidly and we encourage everyone to refer back to Public Health Ontario for the latest scientific information relating to IPAC. The following information is intended to provide health system providers with a summary of available resources and tools for reference. It is not intended to replace guidance or direction from the Ministry of Health, Public Health Ontario, and/or IPAC/Occupational Health and Safety accountabilities within your organization. Who can use this toolkit? This toolkit was developed for the use of care sectors, organizations and providers; however, there is information that is also valuable to individuals and volunteers. IPAC Organizations: National standards and guidance: IPAC Canada, Provincial standards and guidance: Public Health Ontario (PHO) and Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control (PIDAC-IPC) Regional: PHO regional IPAC support teams. Municipal: Public Health Units (PHU)
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October 2020 Version 2.0
Infection Prevention and Control (IPAC) Toolkit
Purpose
The purpose of the toolkit is to support a consistent Infection Prevention and Control (IPAC)
approach across the Ontario West region, with a focus on COVID-19 response by providing
validated and credible resources, based on science, evidence and best practice to build capacity
at the local, organization and individual level.
The toolkit consists of 3 parts: resources, IPAC COVID-19 response process, and a frequently
asked questions (FAQ) page including “what is the difference between Public health units and
public health Ontario.
Note: Information is changing rapidly and we encourage everyone to refer back to Public Health
Ontario for the latest scientific information relating to IPAC. The following information is
intended to provide health system providers with a summary of available resources and tools for
reference. It is not intended to replace guidance or direction from the Ministry of Health, Public
Health Ontario, and/or IPAC/Occupational Health and Safety accountabilities within your
organization.
Who can use this toolkit?
This toolkit was developed for the use of care sectors, organizations and providers; however,
there is information that is also valuable to individuals and volunteers.
IPAC Organizations:
National standards and guidance: IPAC Canada,
Provincial standards and guidance: Public Health Ontario (PHO) and Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control (PIDAC-IPC)
Table of Contents Part A ............................................................................................................................................................ 3
ALL SECTORS – INCLUDES CORE COMPETENCIES ................................................................................ 3
LONG TERM CARE HOME ..................................................................................................................... 8
RETIREMENT HOME ............................................................................................................................. 9
COMMUNITY CARE ............................................................................................................................. 10
ACUTE CARE ........................................................................................................................................ 10
PRIMARY CARE ................................................................................................................................... 12
INDEPENDENT HEALTH CARE FACILITIES ........................................................................................... 15
PART B ......................................................................................................................................................... 16
PUBLIC HEALTH UNITS AND PUBLIC HEALTH ONTARIO .................................................................... 16
PART C ......................................................................................................................................................... 18
Part A Information is categorized by subject types such as: EDUCATION, CORE COMPTENCIES, COVID-
19, STANDARDS & BEST PRACTICE GUIDELINES, AUDIT TOOLS, and CHECKLISTS.
The subject types are available for ALL SECTORS followed by sector specific. If you do not see
your sector listed your resources are in ALL SECTORS section.
ALL SECTORS – INCLUDES CORE COMPETENCIES Topic Subject Type Link Agency Notes
CO
VID
- 1
9
DIRECTIVES & ORDERS
COVID-19 Orders, Directives, Memorandums and Other Resources
Ministry of Health, Ministry of Long-Term Care
COVID-19 Guidance for the Health Sector
Contains current provincial guidance applicable across different health care sectors including hospice, IHF, Consumption and treatment services pharmacies, community labs
Coronavirus disease: For health professionals
Government of Canada
Contains information on product advisories, guidance
IPA
C C
anad
a
EDUCATION
IPAC Canada
IPAC Canada
Opportunities to participate in webinars with some being available to non-members as well. Also has a COVID-19 Web page with links to provincial resources. Non-acute care resources page includes resources for home health, prehospital/EMS, LTCH, Community care, Clinic/ambulatory care,
IPAC Canada Audit Toolkits: Doctor’s office, home care, hospice, occupational health and safety, pharmacy, prehospital, hand hygiene, PPE, Routine practices, Outbreak management, Self-audit tool for ICPs, environmental cleaning, reprocessing, construction/renovation and maintenance
IPAC Canada
Physician/dental offices, mental health, Paediatric and child care, lab IPAC Canada Infection Control Audit toolkit-available for members and for purchase by non-members.
ED
UC
ATI
ON
FU
ND
AM
ENTA
LS
Infection Prevention and Control Fundamentals
Public Health Ontario
Fundamentals training in four streams based on role.
Environment 5. Additional Precautions 6. Health Care Provider
Controls 7. Occupational Health
and Safety 8. Personal Risk
Assessment in:
Acute Care
Community Care Clinic
Community Care Home
Long Term Care
Public Health Ontario
Core Competencies are included in the Fundamentals course; we recommend people complete The Fundamentals. Improve staff IPAC knowledge. 10 modules. 10-15 minutes per module. Free. Set up of PHO account required to access courses. 8 core competency courses
Recommendations for the Prevention, Detection and Management of Occupational Contact Dermatitis in Health Care Settings
Public Health Ontario – PIDAC – IPC
A guide for selection of appropriate hand hygiene products and gloves based on the skin condition
Hand Hygiene E-Learning Tool
IPAC Canada and Discovery Campus
Online education for HCW and volunteers. 15 minutes to complete and certificate issued upon completion
STANDARDS & BEST PRACTICE
GUIDELINES
Hand Hygiene Webpage Best Practices for Hand Hygiene in all Health care settings
Public Health Ontario – PIDAC – IPC
Contains Best Practice for Hand Hygiene document, information on occupational contact dermatitis in health care settings, instructional signs
RO
UTI
NE
PR
AC
TIC
ES &
AD
DIT
ION
AL
PR
ECA
UTI
ON
S
TOOLS & RESOURCES
Routine Practices and Additional Precautions webpage
Public Health Ontario
Information to assist in understanding and applying routine practices and additional precautions in a setting. Here you will find signs and pocket cards for down load, fact sheets, guidance and best practices
EN
VIR
ON
MEN
TAL
CLE
AN
ING
EDUCATION
Environmental Cleaning webpage
Public Health Ontario
Provides information on Environmental cleaning applicable to all health care sectors
Environmental Cleaning Toolkit
Public Health Ontario – PIDAC - IPC
Current toolkit reflects best practices contained within PIDAC’s Environmental Cleaning (EC) document published in 2012. PIDAC’s EC document was updated in 2018 and changes are not reflected in the current EC toolkit
Best Practice Guidelines for Routine Practices and Additional Precautions
Public Health Ontario – PIDAC – IPC
Resources related to routine practices and additional precautions in health care settings across the continuum of care including, but not limited to, pre-hospital care, acute care, complex continuing care, rehabilitation facilities, long-term care, chronic care, ambulatory care and home health care
Best Practice Guidelines for Environmental Cleaning
Public Health Ontario – PIDAC – IPC
This best practice document deals with cleaning and disinfection of the physical environment in health care as they relate to the prevention and control of infections. It is targeted to those who have a role in the management of cleaning/housekeeping services for the health care setting
EDUCATION
Reprocessing webpage
Public Health Ontario
Contains resources to support settings conducting reprocessing of equipment
SUR
VEI
LLA
NC
E
Best Practices for Surveillance of Health Care Associated Infections
Public Health Ontario – PIDAC – IPC
This best practice document is intended as a guide for infection control professionals in acute and long-term care, to ensure that the critical elements and methods of surveillance for health care-associated infections (HAIs) are incorporated into their practice
Best Practices for Prevention of Transmission of Acute Respiratory Infections in All Health Care Settings
Public Health Ontario – PIDAC – IPC
PIDAC-IPC document that deals with the surveillance, reporting and specific interventions for prevention and control of droplet-spread
OR
GA
NIS
MS
Clostridium difficile
Best Practices for Surveillance and Management of Clostridioides difficile in Health Care Settings
Public Health Ontario – PIDAC – IPC
PIDAC-IPC document that deals with the prevention and control of transmission of C. difficile
Annex A: Screening, Testing and Surveillance for Antibiotic-Resistant Organisms (AROs) in All Health Care Settings Antibiotic-Resistant Organisms (MRSA, VRE, CPE, ESBL) for all health-care settings
Public Health Ontario – PIDAC – IPC
PIDAC-IPC document that provides guidance on screening, testing and surveillance of AROs
LAP
SES
IPAC LAPSES
Resources for Preventing Infection and Control Lapses
Public Health Ontario
Resources and advice to support public health units in preventing and investigating lapses in community settings such as clinics, clinical office practices, family health teams, community health and personal services settings
PR
OTO
CO
LS
PROTOCOLS & GUIDELINES
Protocols and Guidelines
Ministry of Health, Ministry of Long-Term Care
Protocols and Guidelines that accompany the Standards are program and topic-specific documents incorporated into the Standards which provide direction on how boards of health shall operationalize specific requirement(s) identified in the Standards
Prevention and Management of COVID-19 in Long-Term Care and Retirement Homes
Public Health Ontario
Compilation of important resources and information to assist in the preventing COVID-19 from entering the home, early identification, preventing spread of COVID-19 and de-escalation of outbreaks
PPE USE IN COHORTING
EDUCATION WEBINAR
COVID-19 Healthcare Worker Personal Protective Equipment (PPE) Use and Cohorting in Long-Term Care and Retirement Homes
Public Health Ontario
Recorded Webinar
COHORTING IN OUTBREAK
FACT SHEET
How to Cohort During an Outbreak of COVID-19 in a Long-Term Care Home COMING SOON
Public Health Ontario
RESPIRATORY OUTBREAKS
OUTBREACK GUIDANCE
Control of Respiratory Infection Outbreaks in Long-Term Care Homes, 2018
Ministry of Health Ministry of Long-Term Care
Guide to assist LTCHs and Public health units with prevention, detection and management of respiratory infection outbreaks which arise from the transmission of common viral pathogens through droplet exposure
for the control of VRE in All Ontario Health Care Facilities Status of VRE Screening and isolation Practices in Ontario Hospitals
impacts of VRE control strategies to help inform the best practice guidance for the prevention of VRE
Hand Hygiene EDUCATION &
RESOURCES Just Clean Your Hands Hospitals
Public Health Ontario
Documents and resources for hospitals to implement the Just Clean your hands program
Patient Safety DATA Patient Safety Indicator results
Health Quality Ontario
A Public Hospitals Act (PHA) regulatory amendment, effective July 28, 2008, requires hospitals to publicly report on patient safety indicators related to hospital-acquired infections, actions undertaken to reduce such infections, and mortality. Under Regulation 965 of the PHA, hospitals are required to disclose the results of each indicator through their website
Antimicrobial Stewardship
RESOURCES ASP in Acute Care Public Health Ontario
Since 2013, Accreditation Canada mandates that all acute care facilities have an antimicrobial stewardship program (ASP)
Best Practice for Infection Prevention and Control for Clinical Office Practice
Public Health Ontario
Assists physicians with their clinical office-based practice. Contains elements derived from legislation and evidence based best practices. Foundational document for IPAC Checklists
REPROCESSING EDUCATION
Recommendations for Education, Training and Certification for Reprocessing in Clinical Office Settings
Public Health Ontario
Provides recommendations on the level of reprocessing education staff who are conducting reprocessing should complete
INFECTION CONTROL RESOURCES
GENERAL RESOURCES
Infection Control Resources and Tools website
Association of Family Health Teams of Ontario
Links to Ontario Health Documents, information on PPE, educational tools (videos), provincial guidance, webinars, PHO resources etc.
COVID-19 GUIDANCE
Guidance for Primary Care Providers in a Community Setting
Ministry of Health, Ministry of Long-Term care
CONGREGATE SETTINGS Topic Subject
Type Link Agency Notes
COVID-19 GENERAL
RESOURCES
COVID-19 Resources for Congregate Living Settings web page
Public Health Ontario
Resources to help staff and administrators address COVID-19 prevention and
Guidance: Congregate Living for Vulnerable Populations
Ministry of Health, Ministry of Long-Term Care
control. Includes information on Cohorting, PPE, recorded webinar on Foundations of COVID-19 prevention and control for congregate living settings plus a lot more
PREPAREDNESS
RESOURCE TOOLKIT
COVID-19 Resource Toolkit for Congregate Living settings COVID-19 Preparedness and Prevention in Congregate Living Settings
MANAGING OUTBREAKS
RECORDED WEBINARS
Managing outbreaks, PPE, Cohorting Managing COVID-19 Outbreaks in Congregate Living Settings
EMS Topic Subject
Type Link Agency Notes
COVID-19 GUIDANCE Guidance for Paramedic Services
Ministry of Health, Ministry of Long-Term Care
COVID-19 CARE PROVISION
EVIDENCE
Evidence Brief: IPAC for First Responders Providing Direct care for suspected or Confirmed COVID-19 Patients
PART B PUBLIC HEALTH UNITS AND PUBLIC HEALTH ONTARIO
PUBLIC HEALTH UNITS PUBLIC HEALTH ONTARIO
Description Official health agencies established by a group of urban and rural municipalities to provide a more efficient community health program Each health unit is governed by a board of health, which is an autonomous corporation under the Health Protection and Promotion Act, and is administered by the medical officer of health who reports to the local board of health.
The Ontario Agency for Health Protection and Promotion (OAHPP - operated under the name Public Health Ontario since 2011), established in 2008 by the OAHPP Act of 2007, is an agent of the Crown and an arm's-length government agency
Number 34 - Shared funding and governance between province and municipalities
Head office in Toronto, 11 lab sites, 5 regional offices
Functions include
• Implementation of Health Protection and Promotion Act (HPPA)
• administer health promotion and disease prevention programs (healthy lifestyles, healthy growth and development programs)
• Sexual health services • Immunization • Inspections/compliance • Outbreak management and reporting • Communicable disease follow-up
• Provide scientific evidence and expert guidance to shape policies and practices for a healthier Ontario.
• Partner with government, public health and health care, to prevent illness and improve health
• Laboratory testing • Research and Analysis
Consultation May be available via telephone or on-site to any organization within the boundaries of the PHU. Varies by PHU.
Focus is on sector level consultation and support. Available to support PHUs, other ministries for IPAC issues Some individual consultation by phone/email available
Regulation/ Enforcement
All PHUs are required to do annual IPAC inspections in Personal Service Settings, childcare.
No regulatory role A PHU may consult with PHO for scientific direction while conducting enforcement
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All PHUs are required to investigate outbreaks in healthcare and institutional settings and investigation may include IPAC assessment. PHUs are required to respond to reports or complaints of IPAC lapses in any type of health care setting as well as community settings
Education • IPAC education provided during inspections and investigations
• Local workshops – outbreaks and IPAC • Targeted IPAC campaigns • Varies by PHU and year. Based on assessment of
local needs.
• Production of evidence –based, sector-specific IPAC educational and training materials
• Focus on knowledge translation and capacity building including “train-the-trainer” approach
• Education and training available online • Various assessment and audit tools for determining IPAC
needs
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PART C FAQ Public Health Ontario Long Term Care Homes FAQ https://www.publichealthontario.ca/-