Infection Preventionist Self-Assessment Name*Date MM slash DD slash YYYY LEVELS OF PROFICIENCY 0 - No Experience | 1 - Some Experience: require assistance / supervision | 2 - Experienced: minimal support needed to perform | 3 - Very Experienced: can perform independently PLEASE CHECK THE APPROPRIATE COLUMN THAT MOST ACCURATELY REFLECTS YOUR LEVEL OF EXPERIENCE:ICP Skills0123Program DevelopmentPolicies & Procedure DevelopmentImplementing Prevention/Control MeasuresStaff EducationHand HygieneBioterrorismPandemic ReadinessIsolation PrecautionsOutbreak InvestigationOutbreak SurveillanceNHSN ReportingOutcome Data CollectionOutcome Data AnalysisOutcome Data InterpretationMulti-Drug Resistant Organisms (MDRO)Blood Borne PathogensUrinary Tract InfectionsSurgical Site InfectionsContinual Survey ReadinessMock SurveysCorrective & Actions PlanningTJC Standards/ComplianceTJC On-Site SurveysCMS Regulations/ ComplianceCMS On-Site SurveysDNV Standards/ ComplianceDNV SurveysAAAHC RegulationsCDC IP GuidelinesOSHAICP Skills0123Public EducationEmployee HealthStaff ManagementMentoringRisk Assessments & ReductionPerformance ImprovementChange ManagementNew Construction/RenovationAcute Care HospitalsAmbulatory CareAmbulatory Surgery CentersLong Term CareBehavioral HealthHome HealthTheraDocMedMinedSafteySurviellorMeditechEpicMcKessonCernerSiemensMidasVigiLanzPatient Population Experience Pediatric Adult Geriatric Other Surveillance Software:By clicking 'Submit', you acknowledge that the information provided is true and accurate to the best of your knowledge and further authorize Galileo Search, LLC. to share the above skills checklist with their clients/potential employees.
