Essentials

by Ron Stoker, MS

Changes in Infection Control

Over the last few years a number of changes have occurred in regulatory and professional associations in regards to those that help protect patients from healthcare-associated infections (HAI) in clinical and other settings around the world. These changes dramatically affected those who   specialize in preventing these infections—known as infection preventionists. In some facilities, staff members were not happy and left to pursue new adventures. In others, more staff was needed to manage the increased workload or to meet the increased educational requirements. In summary, many facilities had to hire more staff.

Most healthcare workers don’t have degrees in infection prevention. They learn it on the job. So, to meet the demands, many facilities had to hire staff without a work history in infection prevention. How does a facility teach these healthcare workers quickly and effectively, and maintain continuous of quality care?

What training is available for new infection preventionists? How do they jump in and learn the necessary information from the ground up? How can this information be learned quickly and completely?

Boot camp! Typically boot camp is a method of orienting an individual into a new way of thinking—a method of transferring knowledge about technical skills. It is one way of immersing yourself in a study. Most associate boot camp with armed forces or military training.

How does training start in the military? For the enlisted man or woman this usually starts with boot camp which is a military basic training course, designed to turn ordinary civilians into soldiers and to weed out those that cannot become soldiers. From what I have been able to find from my research the term originates from the Spanish-America War when the military recruits wore leggings called “boots.”

The U.S. Military has boot camp to teach military recruits to obey. This is really important. In combat the recruit will want to be as safe as possible. Boot camp helps to condition them to fulfill all given orders promptly and without questioning. Boot camp also helps recruits to build up endurance and strength. Another purpose of boot camp and further training is to transfer knowledge about actual combat skills. Recruits also learn to work as a team. They are encouraged to be focused on the “we” aspect of everything that they do.

ISIPS has teamed up with Peggy Prinz Luebbert  MS, MT(ASCP), CIC, CHSP of Healthcare Interventions Inc. to provide an intensive course of training to assist new infection preventionists. The purpose of the program is to completely immerse an individual into the study of infection prevention. The program is divided up into three areas:

Infection Preventionists Boot Camp: Essentials

Infection Preventionists Boot Camp: Intermediate

Infection Preventionists Boot Camp: Advanced

The first course covers the essentials of infection preventionists’ responsibilities. It is composed of 17 seminars. These seminars will be available online on demand as well as on CD or DVD, depending on the seminar. The Essentials’ boot camp course will cover the following topics.

Essentials of an Infection Prevention Program

Key elements of an effective program including: responsibilities, evidence-based practices and written policies, committee structures and mechanisms, risk assessment, annual goal setting and documentation will be discussed.  An example of a formal annual evaluation will help explain the important essentials of this document as well.

Standard Precautions

Standard Precautions are a comprehensive set of practices and precautions designed to prevent transmission of microorganisms amongst patients and healthcare workers, regardless of patient’s diagnosis. Practical examples to help understand the differences between normal flora, colonization and pathogens will begin this seminar. We will then focus on practices associated with patient placement and transportation, management of equipment including issues with such patient owned equipment such as fans, humidifiers, use of PPE, respiratory etiquette displays, safe injection practices and post mortem care. Issues with toys and animals in the facilities will end the program.

Transmission Based Precautions

Practical and effective ways for basic understanding, implementing, teaching and monitoring of the transmission based precautions in a variety of healthcare settings will be covered in this seminar. Examples to explain ordering, patient placement and transport, personnel protective equipment practices, and the management of food, linen and cleaning will also be emphasized.

Bloodborne Pathogen Exposure Control Plan

OSHA’s Bloodborne Pathogen Standard has given us explicit directions on the key elements that must be included in an effective program. We will discuss these elements including: risk categories, controls, signage, education of employees and patients, and mandatory record keeping. The Department of Transportation’s (DOT) disposal, storage and transportation of your regulated waste management will also be introduced.

Sharps Injury Prevention

This seminar focuses on the Exposure Control Plan and methods of locating, acquiring, evaluating, implementing and documenting sharps injury prevention products. The concepts of Tiers of Safety will be addressed. The most common OSHA citations will be discussed.

Tuberculosis Exposure Control Plan

The risk of transmission of tuberculosis is always of concern if patients cannot be screened prior to admission to your facility. This seminar will show practical examples for performing a risk assessment, screening of patients, and the implementation and discontinuing of Airborne Precautions.

Antiseptics and Hand Hygiene

Antiseptics are germicides that we use on skin. We will discuss the use of these agents on hands, skin preparation prior to surgery, procedures, and the placement of intravenous and central vascular lines. We will also discuss issues of hand lotions, artificial nails, body piercings, tattoos and electrolysis.

Microbiology and the Lab’s Role in IP

Fundamental knowledge of microorganisms, their identification, significance and basic laboratory techniques will be covered in this seminar. We will also discuss how the laboratory assists the IP in developing their effective programs particularly during outbreaks.

Common Organisms and Infections

Staph, E. coli, C. diff, Pseudomonas, Enterococci, Enterobacteriacae and other organisms will be discussed focusing on epidemiology, transmission, methods of control, clinical manifestations, and treatments.

Device-related Infections

Infections associated with central lines, urinary Foleys, ventilators and surgical instruments are considered mostly preventable. This seminar will focus on the risks, practical tools, education pieces, monitors and report processes associated with these infections.

Cleaning and Disinfection

Using examples of equipment, instruments and procedures, this seminar will inform the participant of  best practice cleaning processes, the Spalding classifications and effective mechanisms for monitoring processes and patient outcomes.

Sterilization

There are many crucial points in the handling of sterilized instruments that can increase the risk of infections. This seminar will help the new IP understand the spatial population, HVAC, storage of sterile items, and the cleaning, disinfection and sterilization of these items. Types of sterilizers and examples of physical, chemical and biological monitors of these sterilizers will also be discussed.

Surveillance

Surveillance is the systematic method of collecting, consolidating, analyzing and reporting data concerned with infections in your facility. This seminar will describe the assessment of risks, infection definitions, collection of data, basic calculations, analysis and report processes.

Food and Nutrition

Foodborne illnesses and outbreaks are a risk in all healthcare facilities. This section will focus on how and where to find information on local health regulations, employee education requirements, sanitation agents, and practices and introduction to the Hazard Analysis and Critical Control Points (HACCP) principles.

Laundry Services

Towels, patient linen, uniforms and other textiles can be a source of large numbers of pathogens. This section will discuss the safe laundry processes focusing on handling of these textiles from the unit to the laundry services itself.

Employee Health Issues

One of the primary goals of the IP program should be to protect its employees as well as patients. This seminar will discuss the medical health inventory upon hire, training, communicable illness, job related illnesses, immunization programs, and exposure protocols as they relate to IP.

Regulatory/Accrediting Agencies

Many regulatory and accrediting agencies and professional organizations have given assistance as well as increased demands on infection prevention programs. This seminar will cover the role of these agencies which include, but are limited to, AHA, APIC, SHEA, CDC, CMS, FDA, IHI, Joint Commission, NIOSH, OSHA, DOT, EPA, and AAAHC.

For more information on the Infection Preventionists Boot Camp send an e-mail to info@Infectionpreventionistsbootcamp.com.

Ron Stoker is the founder and executive director of the International Sharps Injury Prevention Society (ISIPS) and is a frequent contributor to healthVIE.com. He speaks frequently at national and international meetings on sharps safety, hand hygiene and infection control issues. He is coauthor of the “Compendium of Infection Control Technologies.” For more information on the Compendium, go to www.medicalsafetybook.com. Mr. Stoker is providing a number of webinars focusing on a variety of sharps injury prevention safety products. For more information on the webinars, go to www.isips.org/seminars.html.