INFECTION CONTROL RISK ANALYSIS

INFECTIONS IN THE HOSPITAL

SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE

Staff External
Additional Identification of Knowledge / Support for this
Increased length
Likelihood these will Cleaning / this disease / internal support type infection /
Severity of this of stay / cost to
be present in your Isolation / Staffing infection, Plan of plan for this disease- Public Relative threat* to this facility
type infection the facility due to
patient population Needs Due to this for caring for particular Health, Mutual
this infection
Infection this type patient disease / Aid, Gov.
infection Agencies, etc.

0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A 0 = N/A

0 = N/A
1 = Low 1 = Low 1 = Low 1 = High 1 = High 1 = High
1 = Low
SCORE 2=
2 = Moderate
2 = Moderate 2= 2= 2= 0 - 100%
2 = Moderate Moderate 3 = High Moderate 3 Moderate Moderate
3 = High
3 = High 3 = High = Low or none 3 = Low or none 3 = Low or none

HAI-MRSA 0%
CA-MRSA 0%
VRE 0%
Other MDROs 0%
Tuberculosis 0%
Hepatitis A 0%
Hepatitis B 0%
Hepatitis C 0%
HIV 0%
Enteric Organisms 0%
C. difficile 0%
Chickenpox 0%
Measles 0%
Mumps 0%
Rubella 0%
Pertussis 0%
MERS - Cov 0%
Infunaza virus A& B 0%

Epidemics / Pandemics 0%

AVERAGE SCORE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0%

*Threat increases with percentage.

0 RISK = PROBABILITY * SEVERITY
 0.00 0.00 0.00
0
 INFECTION CONTROL RISK ANALYSIS
PROCEDURAL ISSUES
SEVERITY = (MAGNITUDE - MITIGATION)
PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE

External Support/
Likelihood this Regulations for
Additional Identification & Staff Knowledge
type infection / Increased length of this type
Cleaning / Prevention of this & compliance of
problems with Severity of this stay / cost to the procedure
Isolation / Staffing disease / infection plan for Relative threat*
this process will for the patient facility due to this problem - Public
Needs Due to this / process problem prevention of this
occur in our infection / problem Health, CHS,
Infection / Problem in place particular problem
facility Gov. Agencies,
etc.

0 = N/A 0 = N/A 0 = N/A

0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Low 1 = Low 1 = High
1 = Low 1 = Low 1 = High 1 = High
SCORE 2= 2=
2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate
2 = Moderate 0 - 100%
Moderate Moderate 3 = Low or
3 = High 3 = High 3 = Low or none 3 = Low or none
3 = High 3 = High none
SSI's
Laparoscopic Cholecystectomy
Other Orthopedic Implants 0%
Colon Procedures 0%
Gastric Sleeve Surgery 0%
Total Hip 0%
Hysterectomies (abdominal) 0%
Cesarean Section 0%
Device Associated Event:

Vent-related Events ICUs 0%

CatheterAssociated UTI's 0%

Central Lines Associated Blood

0%
Stream Infections

Equipment Related Infections:

Endoscopes 0%
Central Sterilization 0%
Environmental Related
Infections
Environmental Cleaning &
0%
Disinfection including equipment
C difficile Environmental
0%
Measures
Construction and compliance
0%
with required ICRA Measures
AVERAGE SCORE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0%
*Threat increases with percentage.

0 RISK = PROBABILITY * SEVERITY

0.00 0.00 0.00

0
 INFECTION CONTROL RISK ANALYSIS
COMPLIANCE ISSUES

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY
HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE

Additional Noncompliance External agencies

Possibility of Internal support
Likelihood resources could lead to Monitoring for that encourage
infection to to increase
noncompliance needed if increased length compliance of this comliance with this: Relative threat*
related to compliance with
with this will occur noncompliance of stay, litigation, process in place OSHA, JCAHO,
noncompliance this
occurs cost to the facility CDC, etc.

0 = N/A 0 = N/A 0 = N/A

0 = N/A 0 = N/A 0 = N/A 0 = N/A
1 = Low 1 = Low 1 = High
1 = Low 1 = Low 1 = High 1 = High
SCORE 2 = Moderate 2 = Moderate
2= 2 = Moderate
2 = Moderate
2 = Moderate
2 = Moderate 0 - 100%
Moderate 3 = High 3 = Low or
3 = High 3 = High 3 = Low or none 3 = Low or none
3 = High none

Hand Hygiene 0%

Isolation Procedures 0%

Sterilization 0%
Processes

Skin Antisepsis for

Vascular Lines & 0%
Blood Cultures
Employee Health:

TST Compliance 0%

Immunization
0%
Compliance

Fit-testing Compliance 0%

Bundle

VAEs Prevention
0%
Bundle
CAUTI Prevention
0%
Bundle
CLABSI Prevention
0%
Bundle

SSI Prevention Bundle 0%

PPE adherance in
0%
Isolation Room

AVERAGE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0%

*Threat increases with percentage.

0 RISK = PROBABILITY * SEVERITY
0 0.00 0.00 0.00
 INFECTION CONTROL RISK ANALYSIS
EXPOSURES IN THE HOSPITAL

SEVERITY = (MAGNITUDE - MITIGATION)

PROBABILITY HUMAN PROPERTY BUSINESS PREPARED- INTERNAL EXTERNAL RISK
EVENT IMPACT IMPACT IMPACT NESS RESPONSE RESPONSE

Exposure could Staff knowledge Outside support if

Severity to Additional lead to increased of prevention this type exposure
Prevention /
Likelihood this type employee / resources needed if length of stay, measures for this occurs: CDC, CHS,
Identification of Relative threat*
exposure will occur patient if this this exposure litigation, cost to type of exposure Mutual Aids, Gov.
Exposure in place
exposure occurs occurs the facility & internal support Agencies, Exposure
(worker's comp) if it occurs Hotline, etc.

0 = N/A 0 = N/A 0 = N/A

0 = N/A 0 = N/A 0 = N/A
0 = N/A
1 = Low 1 = Low 1 = Low 1 = High 1 = High
1 = Low
SCORE 2 = Moderate
2 = Moderate 1 = High 2 = Moderate 0 - 100%
2 = Moderate 2 = Moderate 2 = Moderate 2 = Moderate
3 = High
3 = High 3 = Low or none 3 = Low or none
3 = High 3 = High 3 = Low or none
Sharps Injuries
Hepatitis B 0%
Hepatitis C 0%
HIV 0%
Infectious Disease
Exposures
Infunza Virus 0%
Tuberculosis 0%
Hepatitis A 0%
Chickenpox 0%
Measles 0%
Mumps 0%
Rubella 0%
Pertussis 0%
Outbreaks (Internal) 0%
Epidemic (Influx of
Infectious Patients - 0%
External)
Bioterrorism Event 0%
AVERAGE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0%

*Threat increases with percentage.

0 RISK = PROBABILITY * SEVERITY
0 0.00 0.00 0.00
 SUMMARY OF IC RISK ANALYSIS

Procedural Hazards
Infection Hazards

Total for Facility

Compliance

Exposures
Probability 0.00 0.00 0.00 0.00 0.00
Severity 0.00 0.00 0.00 0.00 0.00
Relative Threat to Facility

Hazard Specific Relative Risk:

0.00 0.00 0.00 0.00 0.00

Infection Control Relative Risk

1.00
0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
Relative Impact on Facility

0.00
Infection Hazards Procedural Hazards Compliance Exposures

Probability and Severity of Hazards

1.00
0.90
0.80
0.70
0.60
0.50
0.40
0.30
0.20
0.10
0.00
Probability Severity

IC Risks and Preparedness identified with the highest relative risk at our
Comments on Findings: facility were: