Infection Control Assessment and Response (ICAR) Tool for General Infection Prevention and Control (IPC) Across Settings

Acronyms & Definitions

ICAR: Infection Control Assessment and Response Program

IP: Infection Prevention

Healthcare Personnel IP Competency: The proven ability to apply essential knowledge, skills, and abilities to prevent the transmission of pathogens during the provision of care.

Healthcare Personnel IP Competency-Based Training: The provision of job-specific education, training, and assessment to ensure that healthcare personnel possess IP competency.

Competency Assessment: The verification of IP competency through the use of knowledge-based testing and direct observation. If direct observation is not included as part of a competency assessment, an alternative method to ensure that healthcare personnel possess essential knowledge, skills, and abilities should be used.

Audit: Direct observation or monitoring of healthcare personnel adherence to job-specific IP measures.

Feedback: A summary of audit findings that is used to target performance improvement.

ICAR tools are used to systematically assess a healthcare facility’s IPC practices and guide quality improvement activities (e.g., by addressing identified gaps).

This comprehensive tool is intended to help assess IPC practices in acute care, long-term care, and outpatient settings. It is not currently intended for use in outpatient hemodialysis facilities; resources for outpatient hemodialysis facilities are available at: https://www.cdc.gov/dialysis/prevention-tools/audit-tools.html. The tool includes a series of modules that individuals performing the assessment may use depending on the focus of the assessment. Modules can be selected based on allotted time, facility-specific concerns, or applicability to an organism of concern.

Navigate below to view the various sections of the ICAR tool.

ICAR Instructions | Overview of the ICAR tool and helpful tips [PDF – 2 pages]

ICAR Section 1 | Demographics

Collects facility demographics and critical infrastructure information and is intended for completion by the facility prior to the ICAR (provided as a separate document to send to facility). These questions often require that the facility look up answers or consult with staff members and thus pre-collection often saves time during the actual assessment. The ICAR facilitator should decide if any of the responses need to be verbally reviewed or require further explanation at the beginning of the assessment. If no further clarification is needed, then the facilitator should start on the next section and refer to this section as needed.

Demographics forms for individual healthcare settings available for download to send to facility prior to ICAR assessment:

Demographics – Acute Care [PDF – 6 pages]
Demographics – Long-Term Care [PDF – 6 pages]
Demographics – Outpatient/Ambulatory Care [PDF – 5 pages]

ICAR Section 2 | Facilitator Guide Assessment Modules

Includes various assessment modules for review during a discussion of policies and practices with the facility. These sections cover a variety of infection prevention practices. The questions are formatted to include:

  • Closed-ended questions with “yes/no” response options
  • Open-ended questions which prompt more descriptive responses
    • For the open-ended questions, common responses are often listed below each question to aid in data collection but may contain answers that would not be considered a recommended IPC practice. The facilitator guide should be consulted for the recommended IPC practice
  • Most modules also include corresponding observation components

Click on each Module below to open the tool in a fillable PDF document.

Module 1 – Training, Audits, Feedback [PDF – 5 pages]
Module 2 – Hand Hygiene [PDF – 7 pages]
Module 3 – Transmission-Based Precautions (TBP) [PDF – 30 pages]
Module 4 – Environmental Services (EVS) [PDF – 18 pages]
Module 5 – High-level Disinfection and Sterilization [PDF – 13 pages]
Module 6 – Injection Safety [PDF – 11 pages]
Module 7 – Point of Care (POC) Blood Testing [PDF – 8 pages]
Module 8 – Wound Care [PDF – 9 pages]
Module 9 – Healthcare Laundry [PDF – 9 pages]
Module 10 – Antibiotic Stewardship [PDF – 5 pages]
Module 11 – Water Exposure [PDF – 18 pages]

ICAR Section 3 | Observation Forms

Section 3 is intended for use during observations of infection prevention practices. These sections are meant to assess how some of the discussed policies and practices are being implemented. If this tool is being used as part of an in-person assessment, facilitators might consider expanding observations beyond what is listed in this tool.

  • Observation sections are also included within the corresponding modules in Section 2

Click on each link below to open the form in a fillable PDF document.

Observation Form –  Hand Hygiene [PDF – 3 pages]
Observation Form – Transmission-Based Precautions (TBP) [PDF – 16 pages]
Observation Form –  Environmental Services (EVS) [PDF – 15 pages]
Observation Form – High-level Disinfection and Sterilization [PDF – 10 pages]
Observation Form – Injection Safety [PDF – 10 pages]
Observation Form – Point of Care (POC) Blood Testing [PDF – 7 pages]
Observation Form – Wound Care [PDF – 7 pages]
Observation Form – Healthcare Laundry [PDF – 3 pages]
Observation Form – Water Exposure [PDF – 7 pages]

The TeleICAR team within the Division of Healthcare Quality Promotion can provide training to public health jurisdictions on the use of the ICAR tool. For more information please contact teleicar@cdc.gov.