During the site visits, the ICAP team realized that many facilities need help with policy and protocol development for certain infection control measures. We provided some facilities with examples of existing policies/protocols, or we developed a sample policy for them that they can modify and use based on their needs and requirements. Please click on the policies and protocols below to review all available examples and templates.
Safe Injection Policy Template
Hand Hygiene sample policy (Access fillable file by opening in Google Chrome)
ICAP Standard Precautions Acute Care sample policy
Standard Precautions LTC sample policy
Transmission-based Precautions LTC sample policy
Transmission-based Precautions Acute Care sample policy
Undersink Storage sample Policy
Virginia Dept of Health UTI Incontinence Assessment Policy (fall 2011)
Virginia Dept of Health Perineal Care for Incontinent Residents Policy (fall 2011)
Virginia Dept of Health Prevention of UTIs and CAUTIs Policy (fall 2011)
Central Venous Catheter Policy Template
Environmental Cleaning and Disinfection Policy Template
Indwelling Urinary Catheter Policy Template
Injection Safety Policy Template
PPE for Standard Precautions Policy Template
If you are unable to find a resource on our website, please feel free to contact us by emailing subeach@nebraskamed.com . We will try to help you in finding that resource and, if possible, make it available on our website for others.
Page last reviewed: June 17, 2019