On January 22, 2021, the Centers for Disease Control and Prevention (CDC) updated their Infection Control Assessment and Response (ICAR) tools. The ICAR tools are used to systematically assess a healthcare facility’s infection prevention and control (IPC) practices and to guide quality improvement activities by addressing identified gaps in IPC practices.
Significant changes to the ICAR tool since November 2020 include:
- Additions to reflect updated guidance such as COVID-19 testing in nursing homes
- Increased emphasis on the review of Personal Protective Equipment (PPE) use and handling
- Additions of sections to help guide a video tour as part of a remote TelelCAR assessment or in-person tour of a nursing home.
- Addition of an accompanying facilitator guide to aide with the conduction of the ICAR and create subsequent recommendations for the facility.
The decision by the CDC to conduct an assessment in-person or remotely depends upon several factors, such as available public health resources, the location and remoteness of the facility, and the presence of an active outbreak. An in-person assessment is preferred; however, jurisdictions must individually determine how to best provide assistance in the most timely manner.
Whether the ICAR is conducted as a remote or in-person assessment, it begins with a discussion of current IPC policies and practices. A facility tour will follow to determine how the facility is implementing strategies to prevent the spread of COVID-19 and other infections. Written feedback is then provided to the facility, with follow-up on how the facility is implementing any recommended improvements.
The ICAR tool, the facilitator guide, and the non-facilitator guide can be accessed at: Infection Prevention and Control Assessment Tool for Nursing Homes Preparing for COVID-19 | CDC
Issue
Use of the ICAR tool can be a very strong practice that assists nursing facilities to develop infection control interventions that may decrease the likelihood of spreading COVID-19 and other infections. All appropriate staff should review the ICAR tool and participate in the development of interventions designed to decrease the spread of infection and improve prevention strategies and compliance.
Discussion
- Review policies and procedures and the Infection Prevention and Control Plan to ensure they include the most effective strategies and interventions to prevent and control the spread of COVID-19 and other infections. Use the ICAR tool to identify additional information that is needed to ensure you have a comprehensive IPC Plan.
- Train all staff on the most current infection control and prevention protocols. Document that the trainings occurred and ensure that employees’ files contain the signed training documents so that you can demonstrate compliance with training expectations. Use the ICAR Tool to identify areas of weakness where additional training may strengthen infection prevention and control practices and raise staff awareness in preparation for an ICAR inspection, either in person or via a remote means.
- Periodically audit to ensure that your facility’s infection control and prevention interventions contain the most current guidance and are being followed by all staff members. Consider conducting a mock assessment using the ICAR tool.
