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IPC Nurses Corner – Membership & Registration Form
Please complete this form to join the IPC Nurses Corner community and connect with peers across Europe and beyond.
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1.
Name:
(Vereist.)
*
2.
Country (your country of practice):
(Vereist.)
*
3.
Type of Setting:
Where do you currently work?
(Check all that apply)
(Vereist.)
General hospital
University/academic hospital
Long-term care facility
Outpatient/ambulatory care
Private sector (industry, consultancy)
Public health or policy organization
Research or academic institute
Other (fill in):
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4.
Current Role in IPC:
Describe your current role or title related to infection prevention and control:
(Vereist.)
5.
Preferred Topics:
Which IPC topics interest you most?
(Check all that apply)
IPC audits and feedback
Antimicrobial stewardship (AMS)
Catheter care (e.g., peripheral or central lines)
Hand hygiene improvement strategies
Education and staff training
Patient and family engagement in IPC
Environmental cleaning and disinfection
Outbreak management
Multimodal improvement strategies (e.g., WHO)
Surveillance systems and data use
IPC in long-term or home care
Collaboration with cleaning/support staff
IPC in emergency or critical care settings
Other:
6.
Topics of Expertise:
Which Topics Can You Contribute To?
(Check all that apply)
IPC audits and feedback
Antimicrobial stewardship (AMS)
Catheter care (e.g., peripheral or central lines)
Hand hygiene improvement strategies
Education and staff training
Patient and family engagement in IPC
Environmental cleaning and disinfection
Outbreak management
Multimodal improvement strategies (e.g., WHO)
Surveillance systems and data use
IPC in long-term or home care
Collaboration with cleaning/support staff
IPC in emergency or critical care settings
Other:
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7.
Contact Details:
(Vereist.)
Email address (mandatory):
Organisation (optional):
*
8.
Do you have an
ESCMID membership?
(Vereist.)
Yes, I confirm that I have an ESCMID membership
No, I do not have an ESCMID membership
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9.
Peer-to-Peer Exchange (P2P):
Would you like to be listed in the peer exchange directory, which is openly visible on the network page?
(Vereist.)
Yes, I agree to be listed
No, please keep my information private
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10.
GDPR Compliance:
(Vereist.)
I understand that my personal data will be collected and used solely for the purpose of administering the ESCMID / EUCIC IPC Nurses Corner network, in accordance with GDPR regulations. I can request removal or data correction at any time.
