• CIC Outline
  • LTC-CIP Outline
  • 2022 a-IPC Outline
  • Exam Reference Books
  • Examination Sample Questions

This content outline reflects the results of the Practice Analysis conducted in 2020. Starting August 1st, 2021, the CIC® examination will cover the topics listed in the outline below. This list is not exhaustive and is only meant to be used as an overall guide to help direct applicants’ preparation. Download a PDF.

1) Identification of Infectious Disease Processes (22 items)

  1. Interpret the relevance of diagnostic, radiologic, procedural, and laboratory reports
  2. Identify appropriate practices for specimen collection, transportation, handling, and storage
  3. Correlate clinical signs, symptoms, and test results to identify possible infectious disease
  4. Differentiate between colonization, infection, and pseudo infection (e.g., contamination)
  5. Differentiate between prophylactic, empiric and therapeutic uses of antimicrobials
  6. Assess risk factors for infectious diseases (e.g., travel, vaccination status, immunocompromising factors)
  7. Monitor current and emerging local and global health threats (e.g., local, national, and international public health organizations)

2) Surveillance and Epidemiologic Investigation (22 items)

a. Design of Surveillance Systems

  1. Conduct a risk assessment based on the following: geographic location, demographics of the population served, care, treatment, services provided, analysis of infection prevention data, evidence-based guidelines or recommendations, and regulatory or other requirements as applicable
  2. Develop goals and objectives based upon the risk assessment
  3. Develop a surveillance plan based on the goals identified from the risk assessment
  4. Adopt or establish standardized surveillance definitions
  5. Create a process to identify epidemiologically significant findings and notify relevant parties (e.g., nursing unit, health department, leadership)
  6. Integrate surveillance activities across health care settings (e.g., ambulatory, home health, long term care, acute care, behavioral)
  7. Establish process for identifying individuals with communicable diseases requiring transmission-based precautions and/or follow up (e.g., reporting to health department)
  8. Periodically evaluate the ability of the surveillance plan to obtain relevant data and modify as necessary

b. Collection and Compilation of Surveillance Data

  1. Collect data using standardized definitions
  2. Utilize a systematic approach to obtain and record surveillance data
  3. Organize and manage data in preparation for analysis
  4. Calculate the incidence and/or prevalence of infections
  5. Calculate specific infection rates/ratios (e.g., provider specific, unit specific, device specific, procedure specific, Standardized Infection Ratio)

c. Interpretation of Surveillance Data

  1. Validate surveillance data
  2. Use basic statistical techniques to describe, analyze, and interpret data (e.g., mean, standard deviation, rates, ratios, proportions)
  3. Compare surveillance results to published data and/or other relevant benchmarks (e.g., prior surveillance data, national databases)
  4. Monitor and interpret the relevance of surveillance data (e.g., antimicrobial susceptibility patterns)
  5. Prepare and present findings in a format that is relevant to the audience/stakeholders (e.g., graph, tables, charts)

d. Outbreak Investigation

  1. Verify existence of an outbreak or exposure
  2. Notify appropriate internal and external stakeholders
  3. Collaborate with appropriate persons to establish the case definition, period of investigation, and case finding methods
  4. Define the problem using time, place, person, and risk factors
  5. Formulate hypothesis on source and mode of transmission
  6. Collect additional data (e.g., environmental samples, active surveillance cultures)
  7. Design and implement control measures, including ongoing surveillance
  8. Monitor and evaluate control measures for effectiveness
  9. Prepare and disseminate reports

3) Preventing/Controlling the Transmission of Infectious Agents (22 items)

    1. Develop infection prevention policies and procedures based on law and regulation, manufacturer’s instructions for use, evidence based guidelines and national standards (as applicable)
    2. Collaborate with relevant groups and agencies in planning community/facility responses to biologic threats and disasters (e.g., public health, anthrax, influenza, emerging pathogens)
    3. Identify and implement infection prevention and control strategies related to:
      1. Hand hygiene
      2. Appropriate availability, selection, use, and disposal of Personal Protective Equipment
      3. Appropriate donning and doffing of Personal Protective Equipment
      4. Patient placement, transfer, and discharge
      5. Respiratory hygiene and cough etiquette
      6. Use of patient care products and medical equipment
      7. Principles of safe injection practices (e.g., parenteral medication administration, single use of syringes and needles, appropriate use of single and multi-dose vials)
      8. Compounding medications
    4. Identify and implement strategies related to Transmission based Precautions (in addition to standard precautions)
    5. Adapt transmission based precautions to the specific healthcare setting, the facility design characteristics, and the type of patient interaction
    6. Collaborate with key stakeholders on antimicrobial stewardship programs (e.g., leadership, pharmacist, infectious disease specialist)
      1. Monitor and interpret the relevance of antimicrobial susceptibility patterns
    7. Collaborate with key stakeholders on emergency preparedness and management
      1. Plan for the influx of patients with known/suspected communicable diseases (e.g., bioterrorism, emerging infectious diseases, syndromic surveillance)
      2. Identify infection preventions role in mass casualty incidents and emergency/disaster management
      3. Assess readiness of emergency management plans
      4. Establish infection prevention coverage in emergency situations
      5. Integrate infection prevention strategies into the four phases of emergency/disaster response in the emergency operations plan (e.g., mitigation, preparedness, response, recovery)

4) Employee/Occupational Health (11 items)

    1. Assess and/or develop screening and immunization programs
    2. Collaborate with employee/occupational health regarding counseling, follow up, and work restriction recommendations related to communicable diseases and/or exposures
    3. Collaborate with employee/occupational health to evaluate data related to infection prevention and provide recommendations (e.g., needle stick injuries, splashes)
    4. Collaborate with employee/occupational health to identify healthcare personnel who may represent a transmission risk to patients, coworkers, and communities
    5. Consult on use of alternative infection prevention options (e.g., allergies to products)
    6. Assess risk of occupational exposure to infectious diseases (e.g., Mycobacterium tuberculosis, bloodborne pathogens)
    7. Educate on safe work practices (e.g., PPE, safe injection practices, hand hygiene)

5) Management and Communication (14 items)

a. Planning the Infection Prevention Program

  1. Develop, evaluate, and revise goals, measurable objectives, and plan for the Infection Prevention Program
  2. Assess needs then recommend specific equipment, personnel, information technology, and resources to support the Infection Prevention Program
  3. Participate in cost benefit assessments, efficacy studies, evaluations, and standardization of products and processes
  4. Recommend changes in practice based on regulation, critically appraised literature, clinical outcomes, and financial implications
  5. Assign value to prevention of and/or presence of healthcare associated infection prevention (e.g., cost/benefit analysis, return on investment)

b. Communication

  1. Provide infection prevention findings, recommendations, and reports to appropriate stakeholders
  2. Facilitate and monitor implementation of policies, procedures, and recommendations
  3. Establish a process to communicate notifiable diseases to internal and external stakeholders (e.g., health authority, receiving facility, transitions of care)
  4. Collaborate with internal and external stakeholders in the identification and review of adverse and sentinel events
  5. Evaluate and facilitate compliance with accreditation standards/regulatory requirements
  6. Identify chain of command (e.g., media inquiry)

c. Quality Performance Improvement and Patient Safety

  1. Participate in quality/performance improvement and patient safety activities related to infection prevention (e.g., failure mode and effects analysis, plan do study act)
  2. Develop, monitor, measure, and evaluate infection prevention performance indicators to drive quality improvement initiatives
  3. Select and apply appropriate quality/performance improvement tools (e.g., “fishbone” diagram, Pareto charts, flow charts, Strengths Weaknesses Opportunities Threats, Gap Analysis)

6) Education and Research (12 items)

a. Education

  1. Assess needs, develop goals and measurable objectives for preparing educational offerings
  2. Prepare, present,  coordinate, and/or disseminate educational content that is appropriate for the audience
  3. Identify the differences between the concepts of knowledge, training, and competency
  4. Provide immediate feedback, education, and/or training to healthcare workers when lapses in practice are observed
  5. Facilitate education of patients, families, and others regarding prevention and control measures
  6. Assess the effectiveness of education and learner outcomes (e.g., observation of practice, process measures)
  7. Implement strategies that engage the patient, family, and others in activities aimed at preventing infection

b. Research

  1. Conduct a literature review
  2. Critically appraise the literature (e.g., p value, peer reviewed)
  3. Facilitate incorporation of applicable research findings into practice
  4. Identify opportunities for research related to performance improvement (e.g., effectiveness studies, product trials)

7) Environment of Care (14 items)

    1. Environmental Safety
      1. Recognize and collaborate on processes for a safe care environment (e.g., Heating Ventilation Air Conditioning management, water pathogen management, laundry, waste management, environmental cleaning)
      2. Collaborate on the evaluation and monitoring of environmental cleaning and disinfection practices and technologies
      3. Collaborate with others to select and evaluate environmental cleaning and disinfectant products
      4. Identify infection prevention processes related to recall of potentially contaminated equipment, food, medications, and supplies
      5. Monitor for environmental pathogens (e.g., Legionella, Aspergillus)

 

    1. Recognize and monitor elements important for a safe care environment (e.g., Heating-Ventilation-Air Conditioning, water standards, construction)
      1. Evaluate infection risks and make recommendations during the planning, design, and commissioning phases of construction (e.g., surface choice, number of isolation rooms, type and placement of sinks)
      2. Assess infection risks and provide recommendations for risk mitigation during construction, renovation, and maintenance (e.g., establishment of negative pressure, type of barriers)
      3. Establish through collaboration, the monitoring of risk mitigation during construction, renovation, and maintenance through commissioning

8) Cleaning, Disinfection, Sterilization of Medical Devices and Equipment (18 items)

    1. Identify and evaluate appropriate cleaning, disinfection, and sterilization practices based on intended use (e.g., Spaulding classification)
    2. Collaborate with stakeholders to determine if products are single use, able to be reprocessed internally, or require an external reprocessing facility
    3. Identify and evaluate through direct observations critical steps of cleaning/low level disinfection, high level disinfection, and/or sterilization
    4. Audit the documentation of the process to ensure regulatory and policy requirements are met

This content outline reflects the results of the Practice Analysis conducted in 2021. The Long-Term Care examination will cover the topics listed in the outline below. This list is not exhaustive and is only meant to be used as an overall guide to help direct applicants’ preparation. Download a PDF. 

  1. Long-Term Care Settings (15 items)

a. Ethics

 1. Basic ethical principles

 2. Resident rights and hierarchy of practices for isolation precautions (e.g., precautions are used in the least restrictive way, resident privacy)

b. Communal Gatherings

 1. Impact of interaction on psychosocial well-being

 2. Infection risk associated with communal gatherings

c. Interdisciplinary Team

 1. Infection risk associated with facility and care team demographics (e.g., staff composition, visitors, contracted staff, staffing turnover, ratio of licensed and unlicensed caregivers)

d. Normal Aging Processes

 1. Physiology and immune system changes throughout the lifespan

 2. Pathophysiology and the disease process (e.g., urinary tract, respiratory, skin and soft tissue, gastrointestinal, bloodborne, viral illnesses)

e. Special Populations

 1. Infection risks of complex populations (e.g., residents with medical devices, on dialysis, who need memory support, have cognitive impairment, are on respite or hospice care)

  1. Management and Communication of the Infection Prevention Program (16 items)

a. Infection Prevention Plan

 1. Components of an infection prevention plan (e.g., regulatory and advisory requirements, facility demographics)

 2. Emergency preparedness (e.g., mitigation, preparedness, response, recovery)

 3. Risk assessments (e.g., how to complete and incorporate into plan)

b. Policies and Procedures

 1. Best practices per regulatory and advisory agencies

 2. Implementation science (e.g., key stakeholders, staff buy-in, dissemination, accessibility, feasibility)

c. Education and Training

1. Adult learning principles (e.g., communication techniques, just-in-time training, in-services)

2. Competency assessment (e.g., return demonstration, post tests, auditing)

d. Research

 1. Literature review process

 2. Research study design (e.g., peer reviewed, experimental vs. non-experimental, qualitative vs. quantitative)

 3. Basic statistics (e.g., p value, confidence interval, appropriateness of test)

e. Quality Assurance and Performance Improvement

 1. Performance improvement concepts (e.g., Failure Mode and Effects Analysis [FMEA], Plan Do Study Act [PDSA], Root Cause Analysis [RCA])

 2. Performance indicators to achieve key outcomes

 3. Culture of safety (e.g., reduce Healthcare-Associated Infections [HAIs], hand hygiene champions)

 4. Product and process evaluation (e.g., cost benefit assessments, efficacy studies, standardization of products and processes)

f. Leadership

 1. Leadership styles and principles

 2. Professional development (e.g., seek knowledge, certifications, continuing education courses)

  1. Identification of Infectious Diseases (18 items)

a. Clinical Signs, Symptoms, and Risk Factors to Identify Possible Infectious Diseases

 1. Clinical signs, symptoms, and risk factors to identify possible infectious diseases

b. Diagnostic, Radiologic, Procedural, and Laboratory Reports

 1. Interpretation of diagnostic, radiologic, procedural, and laboratory reports (e.g., chest x-ray reports, culture and sensitivity)

c. Specimen Collection, Transportation, Handling, and Storage

 1. Methods of specimen collection, transportation, handling, and storage

d. Basic Microbiology

1. Basic microbiology terminology (e.g., bacteria, virus, Gram stain)

2. Microbial pathogenicity and host response

e. Epidemiologically Significant Organisms

 1. Epidemiologically significant organisms, including Multidrug Resistant Organisms (MDROs) (e.g., susceptibility pattern interpretation)

 2. Appropriate interventions (e.g., precautions, appropriateness of antimicrobial selection)

  1. Surveillance and Epidemiologic Investigation (24 items)

a. General Principles of Epidemiology

 1. Basic epidemiology

 2. Processes for preventing and mitigating transmission (e.g., cleaning, disinfection, vaccination, transmission-based precautions)

b. Surveillance Design

 1. Surveillance methods and purpose (e.g., prospective, retrospective, targeted/priority directed)

 2. Collection and compilation of surveillance data

 3. Surveillance plan components (e.g., goals and objectives identified from the risk assessment)

c. Outbreak Management

 1. Outbreak management concepts (e.g., case definition, period of investigation, case finding methods)

 2. Outbreak management steps (e.g., reporting, control measures)

d. Collaboration with Internal and External Agencies

 1. Internal organizational structure and culture

 2. Public health guidelines for infection prevention

 3. Public health resources and agencies for infection prevention

e. Reporting

 1. Reporting structure (e.g., internal, governmental, and regulatory agencies)

f. Data Management, Analysis, and, Interpretation

 1. Standardized definitions (e.g., surveillance or case definitions)

 2. Data analysis (e.g., incidence/prevalence, provider specific, unit specific, device specific, procedure specific)

 3. Data collection methods

 4. Report preparation and presentation

 5. Surveillance driven action plans

5. Prevention and Control of Infectious and Communicable Diseases (24 items)

a. Hand Hygiene

1. Key elements for a hand hygiene program

b. Standard and Transmission-Based Precautions

 1. Standard and transmission-based precautions

 2. Injection safety and safe disposal (e.g., multidose vials, IV medication, glucometers, insulin pens)

c. Personal Protective Equipment (PPE)

 1. Appropriate use of Personal Protective Equipment (PPE) (e.g., selection, procurement, donning and doffing, point of care risk assessment)

 2. Regulatory requirements associated with Personal Protective Equipment (PPE) supplies (e.g., Centers for Medicare and Medicaid Services [CMS], Occupational Safety and Health Administration [OSHA], National Institute for Occupational and Safety Health [NIOSH], Food and Drug Administration [FDA], Health Canada)

d. Food Safety

 1. Safe food handling (e.g., regulatory requirements, Hazard Analysis and Critical Control Point [HACCP])

e. Resident Immunizations

 1. Immunization recommendations for residents

f. Ancillary Services

 1. Infection prevention practices required for ancillary services (e.g., podiatry, dental, environmental services)

6. Environment of Care (18 items)

a. Environmental Safety

 1. Safe care environment (e.g., management of ventilation, water, waste, laundry; environmental cleaning; infestation; pets)

 2. Environmental cleaning and disinfection practices and technologies

 3. Environmental pathogens (e.g., Legionella, Aspergillus)

b. Construction and Maintenance

 1. Infection risks associated with construction and maintenance (e.g., Infection Control Risk Assessment [ICRA])

 2. Risk mitigation strategies (e.g., barriers, change air flow, move residents, Personal Protective Equipment [PPE] for maintenance/construction staff)

7. Cleaning, Disinfection, Sterilization of Medical Devices and Equipment (15 items)

a. Cleaning, Disinfection, and Sterilization Practices

 1. Cleaning, disinfection, and sterilization practices based on intended use (e.g., Spaulding classification)

 2. Cleaning, disinfection, and sterilization methods (e.g., UV light, autoclave sterilizer, disinfectant solutions)

8. Antimicrobial Stewardship (11 items)

a. Core Elements of Antimicrobial Stewardship

 1. Core elements of antimicrobial stewardship in Long-Term Care

 2. Antimicrobial susceptibility (e.g., antibiogram, antimicrobial resistance patterns)

 3. Antimicrobials (e.g., prophylactic, empiric, and therapeutic uses of antimicrobials; broad and narrow spectrum)

b. Colonization, Infection, and Contamination

 1. Colonization, infection, and contamination

 2. Appropriate antimicrobial use (e.g., overuse harm, risks, ability to treat)

 3. Diagnostic stewardship (e.g., no urinalysis [UA]/culture asymptomatic resident, standardized Situation Background Assessment Recommendation [SBAR] forms)

9. Employee/Occupational Health (9 items)

a. Occupational Exposure

 1. Occupational exposure, infections, and infectious diseases (e.g., management, treatment, risks)

 2. Requirements for  compliance with regulatory and advisory agencies (e.g., respiratory protection programs, sharps safety)

b. Fitness for Duty

 1. Work restrictions associated with communicable diseases (e.g., exposure, illness, compliance with Personal Protective Equipment [PPE] procedures)

c. Employee Immunizations

 1. Immunization recommendations for staff

 

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  1. Processes to Identify Infectious Diseases (13 items)

    1. Interpret the relevance of diagnostic, radiologic, procedural, and laboratory reports
    2. Identify appropriate practices for specimen collection, transportation, handling, and storage
    3. Correlate clinical signs, symptoms, and test results to identify possible infectious disease
    4. Differentiate between colonization, infection, and pseudo infection (e.g., contamination)
    5. Differentiate between prophylactic, empiric, and therapeutic uses of antimicrobials
    6. Assess risk factors for infectious diseases (e.g., travel, vaccination status, immunocompromising factors)
    7. Monitor current and emerging local and global health threats (e.g., local, national, and international public health organizations)

  1. Surveillance and Epidemiologic Investigation (14 items)

    1. Design of Surveillance Systems

      1. Conduct a risk assessment based on the following: geographic location, demographics of the population served, care, treatment, services provided, analysis of infection prevention data, evidence-based guidelines or recommendations, and regulatory or other requirements as applicable (e.g., licensing requirements)
      2. Develop goals and objectives based upon the risk assessment
      3. Develop a surveillance plan based on the goals and objectives identified from the risk assessment
      4. Adopt or establish standardized surveillance definitions
      5. Create a process to identify epidemiologically significant findings and notify relevant parties (e.g., nursing unit, health department, leadership)
      6. Integrate surveillance activities across health care settings (e.g., ambulatory, home health, long term care, acute care, behavioral)
      7. Establish process for identifying individuals with communicable diseases requiring transmission-based precautions and/or follow up (e.g., reporting to health department)
      8. Periodically evaluate the ability of the surveillance plan to obtain relevant data and modify as necessary

    1. Collection and Compilation of Surveillance Data

      1. Collect data using standardized definitions (e.g., surveillance or case definitions)
      2. Utilize a systematic approach to obtain and record surveillance data
      3. Organize and manage data in preparation for analysis
      4. Calculate the incidence and/or prevalence of infections
      5. Calculate specific infection rates/ratios (e.g., provider specific, unit specific, device specific, procedure specific, Standardized Infection Ratio)

    1. Interpretation of Surveillance Data

      1. Validate surveillance data
      2. Use basic statistical techniques to describe, analyze, and interpret data (e.g., mean, standard deviation, rates, ratios, proportions)
      3. Compare surveillance results to published data and/or other relevant benchmarks (e.g., prior surveillance data, national databases)
      4. Monitor and interpret the relevance of surveillance data (e.g., antimicrobial susceptibility patterns)
      5. Prepare and present findings in a format that is relevant to the audience/stakeholders (e.g., graph, tables, charts)

    1. Identify actions based on surveillance data

      1. Develop and/or facilitate action plans based on surveillance findings
      2. Monitor effectiveness of action plan and revise as necessary
      3. Identify when to implement an epidemiological study or outbreak investigation to investigate a potential problem (e.g., case control, cohort studies)

    1. Outbreak and exposure investigation

1. Verify existence of outbreak or exposure (e.g., diagnosis)

2. Notify appropriate internal and external stakeholders (e.g., senior leadership, medical provider, risk management, public health)

3. Collaborate with appropriate persons to establish the case definition, period of investigation, and case finding methods

4. Define the problem using time, place, person, and risk factors

5. Formulate hypothesis on source and mode of transmission

6. Collect additional data (e.g., environmental samples, active surveillance cultures)

7. Design and implement control measures, including ongoing surveillance

8. Monitor and evaluate control measures for effectiveness

                   9. Prepare and disseminate reports

  1. Preventing/Controlling the Transmission of Infectious Agents (14 items)

a. Develop infection prevention policies and procedures based on law and regulation, manufacturers instructions for use, evidence based guidelines and national standards (as applicable)

b. Collaborate with relevant groups and agencies in planning community/facility responses to biologic threats and disasters (e.g., public health, anthrax, influenza, emerging pathogens)

c. Identify and implement infection prevention strategies related to standard precautions wherever healthcare is provided:

1. Hand hygiene

2. Appropriate availability, selection, use, and disposal of Personal Protective Equipment

3. Appropriate donning and doffing of Personal Protective Equipment

4. Patient placement, transfer, and discharge

5. Respiratory hygiene/cough etiquette

6. Use of patient care products and medical equipment

7. Principles of safe injection practices (e.g., parenteral medication administration, single use of syringes and needles, appropriate use of single and multi-dose vials)

8. Compounding medications

d. Identify and implement strategies related to Transmission based Precautions (in addition to standard precautions)

e. Adapt transmission based precautions to the specific healthcare setting, the facility design characteristics, and the type of patient interaction

f. Collaborate with key stakeholders on antimicrobial stewardship programs (e.g., leadership, pharmacist, infectious disease specialist)

      1. Monitor and interpret the relevance of antimicrobial susceptibility patterns (e.g., antibiogram)

g. Collaborate with key stakeholders on emergency preparedness and management

      1. Plan for the influx of patients with known/suspected communicable diseases (e.g., bioterrorism, emerging infectious diseases, syndromic surveillance)

      2. Identify infection preventions role in mass casualty incidents and emergency/disaster management

      3. Assess readiness of emergency management plans

      4. Establish infection prevention coverage in emergency situations

      5. Integrate infection prevention strategies into the four phases of emergency/disaster response in the emergency operations plan (e.g., mitigation, preparedness, response, recovery)

  1. Employee/Occupational Health (7 items)

a. Assess and/or develop screening and immunization programs

b. Collaborate with employee/occupational health regarding counseling, follow up, and work restriction recommendations related to communicable diseases and/or exposures

c. Collaborate with employee/occupational health to evaluate data related to infection prevention and provide recommendations (e.g., needle stick injuries, splashes)

d. Collaborate with employee/occupational health to identify healthcare personnel who may represent a transmission risk to patients, coworkers, and communities

e. Consult on use of alternative infection prevention options (e.g., allergies to products)

f. Assess risk of occupational exposure to infectious diseases (e.g., Mycobacterium tuberculosis, bloodborne pathogens)

g. Educate on safe work practices (e.g., PPE, safe injection practices, hand hygiene)

  1. Management and Communication of the Infection Prevention Program (9 items)

    1. Planning the Infection Prevention Program

1. Develop, evaluate, and revise goals, measurable objectives, and plan for the Infection Prevention Program

2. Assess needs then recommend specific equipment, personnel, information technology, and resources to support the Infection Prevention Program

3. Participate in cost benefit assessments, efficacy studies, evaluations, and standardization of products and processes

4. Recommend changes in practice based on regulation, critically appraised literature, clinical outcomes, and financial implications

5. Assign value to prevention of and/or presence of healthcare associated infection prevention (e.g., cost/benefit analysis, return on investment)

    1. Communication

1. Provide infection prevention findings, recommendations, and reports to appropriate stakeholders

2. Facilitate and monitor implementation of policies, procedures, and recommendations

3. Establish a process to communicate notifiable diseases to internal and external stakeholders (e.g., health authority, receiving facility, transitions of care)

4. Collaborate with internal and external stakeholders in the identification and review of adverse and sentinel events

5. Evaluate and facilitate compliance with accreditation standards/regulatory requirements

6. Identify chain of command (e.g., media inquiry)

    1. Quality Performance Improvement and Patient Safety

      1. Participate in quality/performance improvement and patient safety activities related to infection prevention and control (e.g., failure mode and effects analysis, plan-do-study- act)
      2. Develop, monitor, measure, and evaluate performance indicators to drive quality improvement initiatives
      3. Select and apply appropriate quality/performance improvement tools (e.g., “fishbone” diagram, Pareto charts, flow charts, Strengths-Weaknesses-Opportunities-Threats, Gap Analysis)

  1. Education and Research (8 items)

    1. Education

      1. Assess needs, develop goals and measurable objectives for preparing educational offerings
      2. Prepare, present, coordinate, and/or disseminate educational content that is appropriate for the audience
      3. Identify the differences between the concepts of knowledge, training, and competency
      4. Provide immediate feedback, education, and/or training to healthcare workers when lapses in practice are observed
      5. Facilitate education of patients, families, and others regarding prevention and control measures
      6. Assess the effectiveness of education and learner outcomes (e.g., observation of practice, process measures)
      7. Implement strategies that engage the patient, family, and others in activities aimed at preventing infection

    1. Research

      1. Conduct a literature review
      2. Critically appraise the literature (e.g., p value, peer reviewed)
      3. Facilitate incorporation of applicable research findings into practice
      4. Identify opportunities for research related to performance improvement (e.g., effectiveness studies, product trials)

  1. Environment of Care (9 items)

    1. Environmental Safety

      1. Recognize and collaborate on processes for a safe care environment (e.g., Heating Ventilation Air Conditioning management, water pathogen management, laundry, waste management, environmental cleaning)
      2. Collaborate on the evaluation and monitoring of environmental cleaning and disinfection practices and technologies
      3. Collaborate with others to select and evaluate environmental cleaning and disinfectant products
      4. Identify infection prevention processes related to recall of potentially contaminated equipment, food, medications, and supplies
      5. Monitor for environmental pathogens (e.g., Legionella, Aspergillus)

    1. Construction and renovation

1. Evaluate infection risks and make recommendations during the planning, design, and commissioning phases of construction (e.g., surface choice, number of isolation rooms, type and placement of sinks)

2. Assess infection risks and provide recommendations for risk mitigation during construction, renovation, and maintenance (e.g., establishment of negative pressure, type of barriers)

3. Establish through collaboration, the monitoring of risk mitigation during construction, renovation, and maintenance through commissioning

  1. Cleaning, Disinfection, Sterilization of Medical Devices and Equipment (11 items)

a. Identify and evaluate appropriate cleaning, disinfection, and sterilization practices based on intended use (e.g., Spaulding classification)

b. Collaborate with stakeholders to determine if products are single use, able to be reprocessed internally, or require an external reprocessing facility

c. Identify and evaluate through direct observations critical steps of cleaning/low level disinfection, high level disinfection, and/or sterilization

d. Audit the documentation of the process to ensure regulatory and policy requirements are met

References have been categorized as primary and secondary sources for content information. Most questions are based on material in the primary references. Secondary references may be useful to help clarify more detailed issues in specific practice settings or content areas such as microbiology.

Primary References: CIC & a-IPC

  • Grota P, et al. APIC Text of Infection Control and Epidemiology, online ed., APIC.
  • Meehan, AK, Campbell, EA, Dudeck, MA, Edwards, JR, & Herzig, C. Fundamental Statistics & Epidemiology in Infection Prevention,1st ed., APIC, 2016.
  • Kulich P, Taylor D, eds. The Infection Preventionist’s Guide to the Lab, APIC, Washington, DC, 2012.
  • Brooks, Kathy. Ready Reference for Microbes, 4th ed., APIC; 2018.

Secondary References: CIC & a-IPC

  • Current Recommendations of the Advisory Committee on Immunization Practices (ACIP).
  • Current guidelines, standards, and recommendations from CDCSHEAHICPAC, and Public Health Agency of Canada.
  • AORN guidelines for perioperative practice.
  • The Pink Book - Epidemiology and Prevention of Vaccine Preventable Diseases.
  • Pickering, Larry K, ed. Red Book, 30th ed., Elk Grove Village, IL: American Academy of Pediatrics; 2018.
  • Ontario Agency for Health Protection and Promotion (Public Health Ontario), Provincial Infectious Diseases Advisory Committee. Best practices for environmental cleaning for prevention and control of infections in all health care settings. 3rd ed. Toronto, ON: Queen’s Printer for Ontario; 2018.
  • Ontario Agency for Health Protection and Promotion (Public Health Ontario), Provincial Infectious Diseases Advisory Committee. Interim guide for infection prevention and control of Candida auris. Toronto, ON: Queen's Printer for Ontario; 2019.

References have been categorized as primary and secondary sources for content information. Most questions are based on material in the primary references. Secondary references may be useful to help clarify more detailed issues in specific practice settings or content areas such as microbiology.


Primary References: LTC-CIP

  • APIC Text of Infection Control and Epidemiology, 4th ed.,
  • Volume I, Volume II and Volume III, APIC, Washington, DC,
  • Kulich P, Taylor D, eds. The Infection Preventionist’s Guide to the Lab, APIC, Washington, DC, 2012.
  • Heymann, D., ed. Control of Communicable Diseases Manual, 20th edition, Washington, DC: American Public Health Association
  • Brooks, Kathy. Ready Reference for Microbes, 4th ed., APIC
  • Infection Prevention guide to long term care 2nd edition (APIC)
  • Advisory Committee on Immunization Practices (ACIP) – Centres for Disease Control

Secondary references

  • 10 Ethical Principles in Geriatrics and Long Term Care  

https://www.hmpgloballearningnetwork.com/site/altc/content/10-ethical-principles-geriatrics-and-long-term-care-2 

  • Position on Ethics Committees in Long Term Care 

https://paltc.org/amda-white-papers-and-resolution-position-statements/position-ethics-committees-long-term-care
 

The following sample questions have not appeared on previous editions of the exam and have not undergone the full test development process. These are provided to APIC as examples of the types of questions included on the exam, but do not necessarily represent current test criteria or the level of difficulty.

Identification of Infectious Disease Processes
1.    Koplik spots are a symptom that is specific to which of the following viruses:
a.    Varicella
b.    Rubella
c.    Rubeola
d.    Coxsackievirus

Correct answer is c
Pinkbook of Vaccine Preventable Diseases

2.    Anti-HBc indicates
a.    Prior infection with Hepatitis B.
b.    Status as a Hepatitis B carrier.
c.    New infection with Hepatitis B.
d.    Prior immunization with Hepatitis B vaccine.

Correct answer is a
Pinkbook of Vaccine Preventable Diseases


3.    Serologic markers of a recent infection include:
a.    IgG
b.    IgM
c.    IgA
d.    IgC

Correct answer: b
Pinkbook of Vaccine Preventable Diseases

4.    A gram stain of cerebrospinal fluid showing gram negative diplococci strongly suggest which of the following:
a.    Aseptic Meningitis
b.    Pneumococcal disease
c.    Meningococcal disease
d.    H. influenzae disease

Correct answer: c 
Pinkbook of Vaccine Preventable Diseases

Surveillance and Epidemiologic Investigation
5.    The first step in an outbreak investigation is:
a.    Develop a case definition.
b.    Begin case finding.
c.    Confirm the outbreak.
d.    Notify senior leadership.

Correct answer: c
APIC Text Chapter 12

6.    Surveillance is defined as
a.    Systematic collection of data for reporting.
b.    Focused data collection to detect problems.
c.    Targeted collection of data for quality assurance.
d.    Systematic collection of data for planning, implementation, and evaluation.

Correct answer: d 
APIC Text Chapter 11

7.    Endemic infections are those infections that occur in a population:
a.    Rarely.
b.    at a usual rate. 
c.    at a higher-than-normal rate.
d.    that has never been affected by them before.

Correct answer: b
APIC Text Chapter 11


8.    Pandemic infections are those that occur
a.    In a narrow geographic area.
b.    In a single country affecting many people.
c.    Among a previously unaffected population.
d.    In a widespread geographic area affecting much of the population.

Correct answer: d
Reference APIC Text Chapter 11

Preventing/Controlling the Transmission of Infectious Agents
9.    Virulence describes:
a.    The reservoir of an organism.
b.    A factor related to a disease host.
c.    The ability of an organism to invade a host and cause disease.
d.    The ease with which an organism can be killed/inactivated by disinfectants.

Correct answer: c
Reference APIC Text Chapter 22

10.    The Advisory Committee on Immunization Practices (ACIP) recommends which of the following vaccines for all persons over the age 65?
a.    MMR
b.    TDaP
c.    Varicella
d.    Pneumococcal 

Correct answer: d
Reference APIC Text Chapter 62

11.    Important interventions to prevent central line-associated bloodstream infections include:
a.    Ensuring that central lines are rotated periodically.
b.    Ensuring all central lines are inserted in a procedure room.
c.    Ensuring that skin is cleansed with iodophor prior to insertion.
d.    Evaluating products to ensure all needed supplies are contained within insertion kits.

Correct answer: d
APIC Text Chapter 35

12.    Important interventions to prevent catheter-associated urinary tract infections include:
a.    Regularly changing urine collection bags.
b.    Obtaining a urine culture when a foul odor is present.
c.    Obtaining a urine culture urine when pyuria is noted.
d.    Ensuring urinary catheters are inserted for appropriate indications.

Correct answer: d
APIC TEXT Chapter 34


Employee and Occupational Health
13.    Elements of an Occupational Health program include:
a.    Surveillance of patient illnesses.
b.    Education of personnel about their risk of disease acquisition.
c.    Investigation of patients exposed to ill healthcare personnel.
d.    Notification of patients exposed to ill healthcare personnel.

Correct answer b
APIC Text Chapter 102

14.    A pregnant healthcare worker with previous history of varicella vaccination is assigned to care for an individual with disseminated shingles. She should:
a.    be reassigned to care for other patients.
b.    utilize Standard/Routine and Airborne Precautions while caring for the patient.
c.    receive an additional varicella vaccine during pregnancy.
d.    be advised to consult with her provider about potential exposure.

Correct answer b
APIC Text Chapter 106, Table 106-2

Management and Communication
15.    Competence may be thought of as:
a.    the process of teaching a skill to a learner.
b.    the ability to put knowledge into action.
c.    the process of attaining knowledge and skill.
d.    the ability to identify problems in the workplace.

Correct answer: b
APIC Text Chapter 2

16.    According to the APIC Competency Model the Early Novice IP is should pursue competency in all the following except:
a.    Developing policies.
b.    Learning the basics of epidemiology.
c.    Performing advanced analysis of statistics.
d.    Participating in ongoing learning opportunities.

Correct answer c
APIC Text Chapter 2

Education and Research
17.    The most basic goal of infection prevention education is:
a.    Ensuring knowledge of policies and procedures.
b.    Identifying risk for disease transmission.
c.    Developing competency in infection prevention.
d.    Developing evidence-based procedures.

Correct answer c
APIC Text Chapter 3 – Key Concepts

18.    A competency statement describes:
a.    Responsible personnel.
b.    Steps in a psychomotor skill.
c.    Recommended performance measures.
d.    Worker skill, knowledge, and mind set needed to perform a duty.

Correct answer d
APIC Text Chapter 3

Environment of Care
19.    Infection preventionists should review which of the following when assessing the environment of care?
a.    Outdoor air quality.
b.    Weather related outdoor humidity.
c.    Air pressure relationships within the facility.
d.    Elevation of the head of the bed for patients on ventilators.

Correct answer c
CDC Environmental Infection Control Guidelines

20.    The temperature of cold food storage (e.g., refrigerators) is monitored and recorded every 4 hours. When reviewing the temperature log the IP notes that the refrigerator temperature has been recorded as being 45 degrees Fahrenheit for the previous 16 hours. What action should be taken first?
a.    No action is needed.
b.    A work order to fix the refrigerator should be placed. 
c.    Discard food that has not been maintained at proper temperatures.
d.    Determine if the temperature is being recorded after the refrigerator doors have been open for restocking.

Correct answer c
APIC Text Chapter 111 Key concepts

Cleaning, Sterilization, and Disinfection
21.    Critical items, according to the Spaulding Classification, are those that:
a.    Contact mucous membranes.
b.    Contact normally sterile body sites.
c.    Must be high-level disinfected.
d.    Include surfaces in critical care units and surgery.

Correct answer b
APIC Text Chapter 31

22.    Cleaning is defined as:
a.    Removal of organic material.
b.    Applying sporicidal solutions to surfaces.
c.    Inactivation and killing of microorganisms.
d.    Activities that achieve the absence of pathogenic levels of microorganisms.

Correct answer a
APIC Text Chapter 31
 

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