Questionnaire for CHICA-Canada Members

Virox Technologies Inc. is looking forward to sponsoring the 2ndbi-annual Disinfection and Sterilization Day at the 2012 CHICA-Canada National Education conference (Saskatoon, June 16-21, 2012). In order to ensure the topics covered are relevant and of interest to the Infection Control Community we are hoping you will take a few minutes to answer this questionnaire. Please circle the correct response or add a comment where indicated.

  1. Of the following what best describes your role:
  2. Infection Prevention and Control Professional___
  3. Public Health Inspector / Nurse___
  4. Epidemiologist___
  5. Medical Microbiologist ___
  6. Medical Laboratory Technologist___
  7. Community Care Healthcare Provider___
  8. Pre-Hospital / Emergency Services___
  9. Consultant___
  10. Other Role: ______
  1. Of the following what best describes the facility you work in:
  2. Acute Care___
  3. Long Term Care___
  4. Rehabilitation___
  5. Community Care ___
  6. Occupational Health___
  7. Pre-Hospital/Emergency___
  8. Police / Fire/Corrections___
  9. Other (please describe) ______
  1. Of the following applications for Disinfectants which of the following are you most interested in learning about? Please rank the following in order of most to least interested.
  2. Disinfection of Environmental Surfaces___
  3. Disinfection of non-critical medical devices and patient monitoring equipment___
  4. Disinfection of semi-critical medical devices___
  5. Chemical Sterilization of critical medical devices___
  6. Sterilization of critical medical devices___
  1. Of the following topics related to Cleaning, Disinfection of Environmental Surfaces and Non-Critical Devices are you most interested in learning about? Please rank the following in order of most to least interested.
  2. The role of the Environment in transmission of infections___
  3. Implementing a Quality Control Programs for Environmental Service___
  4. New Technologies in Disinfection ___
  5. Effective use of Disinfectants for Pre-Hospital and Support Services___
  6. Effective use of Disinfectants for Community Care Programs___
  7. Removal and Management of Biofilm___
  8. Understanding disinfectant chemistries___
  9. Patient Safety aspects of using disinfectants___
  10. Occupational Health and Safety aspects of using disinfectants___
  11. Material Compatibility issues and resolution for disinfectant use___
  1. Of the following topics related to Cleaning, Disinfection of Semi-Critical and Critical Devices are you most interested in learning about? Please rank the following in order of most to least interested. Please rank the following in order of most to least interested.
  2. New Technologies in Disinfection ___
  3. Ensuring Disinfection & Sterilization Compliance in Central Processing___
  4. Effective use of Disinfectants for Pre-Hospital and Support Services___
  5. Effective use of Disinfectants for Community Care Programs___
  6. Removal and Management of Biofilm___
  7. Understanding disinfectant chemistries___
  8. Understanding sterilization devices___
  9. Patient Safety aspects of using disinfectants___
  10. Occupational Health and Safety aspects of using disinfectants___
  11. Material Compatibility issues and resolution for disinfectant use___
  1. What additional information would you be interested in learning with regards to cleaning, disinfection and sterilization?

DEADLINE DATE FOR RESPONSE: March 15, 2011

OPTIONAL:

Name ______

Telephone: ______

Email: ______

Thank you for your assistance in developing the 2nd bi-annual Disinfection and Sterilization Day.

2012 Disinfection and Sterilization Day, June 2012

Alexis Silverman RN BA BScN CICNicole Kenny BSc Assoc. Chem

Co-ChairCo-Chair

Please forward your completed survey to:

CHICA-Canada

Email:

Fax: 1-204-895-9595

1