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Champion’s Kit Questionnaire

Your participation in this survey well help us identify and improve how we can help you.

Questions marked with * are required.

When did you receive The Champion’s Kit?

When did you begin using The Champion's Kit in your facility?

How helpful was The Champion’s Kit in establishing an infection prevention awareness program in your facility?

What steps have you taken to implement the tools from The Champion’s Kit in your facility so far?

What was the most useful aspect in the kit?

What was the least useful aspect?

What has been the most challenging obstacle to overcome in setting up an infection prevention awareness program with other staff at your facility?

Has this toolkit assisted you in overcoming these obstacles?

How have employees/colleagues reacted to this program?

Has the program increased the awareness of your infection prevention activities to the C-Suite?

Have you seen any impact on hospital acquired infections? I.e. lowered HAI rates, increased compliance with items such as hand hygiene, use of personal protective equipment, etc.

Have you seen any increase in employee compliance to hand hygiene or other infection control practices?

Please share any early results or additional feedback.

Would you be willing to implement the program further and take part in a case study, providing regular updates? If so, please provide your contact information below:


APIC Logo PDI® is proud to support Infection Preventionists worldwide as a 2010 APIC Strategic Partner. To learn more about the APIC Strategic Partner Program and APIC's Corporate Guidelines, please visit www.apic.org/partners.