# Standard for Infection Prevention and Control (IPAC), 2023

Occupational therapists protect the public by using best practices to minimize the risks of transmitting infection. Public Health Ontario (PHO) defines IPAC as “evidence-based practices and procedures that, when applied consistently in health care settings, can prevent or reduce the risk of transmission of microorganisms to health care providers, clients, patients, residents and visitors” (PHO, 2021).
In addition to infectious agents, occupational therapists must be aware of other environmental factors that could impact client health and safety, such as insect infestations or food-borne illnesses. Refer to Appendix 1 for IPAC resources.

Occupational therapists are expected to:

Identify and access current and best-practice IPAC resources relevant to the practice setting.

Develop or apply existing IPAC policies and procedures including routine practices such as hand hygiene and the selection and use of personal protective equipment. Ensure that equipment is cleaned and maintained.

Inform clients and others about IPAC best practices as they relate to service provision.

Ensure that protocols are in place when risks of transmission are not preventable and address adverse events related to IPAC. Use clinical judgement, collaborate with clients to find alternative options if risks remain high, and document these processes.

Advocate for adequate resources to support IPAC best practices.

Conduct a point-of-care risk assessment.

Understand and apply evidence-informed cleaning, disinfection, and sterilization protocols for the practice setting’s physical environment, devices, and equipment. Comply with the equipment manufacturer’s instructions for use and best practices for cleaning. Appendix 2 explains the three types of equipment and devices: non-critical, semi-critical, and critical.

Follow additional College and public health directives when working with practice modalities requiring IPAC measures.

Use clinical judgement to determine when commonly used items such as pens and measuring tapes should be reused, cleaned, or discarded.

As best practices for IPAC evolve, review and update protocols for cleaning, disinfecting, and sterilizing devices and equipment.

Infection Prevention and Control Canada: Infection Prevention and Control Resources (n.d.)

Public Health Agency of Canada: Infection Control Guideline Series (n.d.)

Public Health Ontario: Infection Prevention and Control (2021)

Provincial Infectious Diseases Advisory Committee Best Practice Documents

Best Practices for Cleaning, Disinfection and Sterilization of Medical Equipment/Devices in All Health Care Settings (2013)

Best Practices for Environmental Cleaning for Prevention and Control of Infections in All Health Care Settings (2018)

Best Practices for Hand Hygiene in All Health Care Settings, 4th Edition (2014)

Infection Prevention and Control for Clinical Office Practice (2013)

Public Health Ontario Online Learning (2020)

PHO classifies the equipment used by health professionals as non-critical, semi-critical, or critical. PHO uses the term “reprocessing” to refer to the steps for cleaning, disinfecting, and sterilizing medical equipment or devices (PHO, 2013). Occupational therapists must be knowledgeable about the PHO classifications of medical equipment and about best practices for reprocessing.

This chart outlines PHO’s classification system and notes best practices for cleaning, disinfecting, and sterilizing.

Classification of Equipment and DevicesDefinitions
and ExamplesBest Practices for ReprocessingNon-criticalThose that do not touch the client directly or touch only the client’s intact skinExamples: splints, goniometers, blood pressure cuffs, and stethoscopesCleaning; may also require low-level disinfection or single useSemi-criticalThose that encounter non-intact skin or mucous membranes but do not penetrate themExamples: respiratory equipment and probesMeticulous cleaning followed by, at a minimum, high-level disinfectionCriticalThose that enter sterile tissues

Examples: indwelling catheters and footcare equipmentMeticulous cleaning followed by sterilization