This part is for IPC

IPC Notes

Action Done by IPC Practitioner

Signature
This report will be sent to Hospital Director and/or Medical Director and Copy to the Department Direct Director

For Department Director after receiving a copy of the report immediate action is required

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.