Example – infection prevention and control programme = (intention to do)

Statement	Detailed information	Date for review	
IP & C lead is responsible for infection
Prevention and control

	XXXX is named lead (job title).  This person
will ensure that:

•	Policies are updated
•	Identify how and when they will be reviewed
•	How and when staff will receive training
•	How and when staff policies will be monitored for compliance		
Relevant policies are available

	List of policies available

•			
Policies approved

	Date approved and by who		
Policies will be reviewed

Statement	Date of revision and by who

Detailed information	

Date for review	
All staff will receive induction training	Names of staff and dates of training	

	
All staff will receive on-going training	Names of staff and dates of training	Refresher due

	
Contact for advice	GP, name and telephone

HPA, name and telephone

PCT infection prevention and control
		
Audit programme planned	Essential Steps

Date

Who

Results

Mattress Audit

Date

Etc

Equipment cleaning