Egyptian Fellowship Board Infection Control Curriculum…كافحة العدوي... · and...

Egyptian Fellowship Board

Infection Control Curriculum

Preface

T he Egyptian Fellowship Board and the Infection Control Scientific Council worked

collaboratively to make this curriculum available for trainees’ guidance and sup-

port. Postgraduate medical education world wide are now governed by sets of academic

standards that describe the qualities and abilities of graduates. In addition, there are

standards for the training processes , trainers’ selection and methods of assessment.

standards ensure transparency and clarify expectations.

The Egyptian fellowship board has already defined and published its standards for the

general and professional competencies expected from our graduates in different special-

ties upon successful completion of training. These expectations are clearly reflected in

the infection control curriculum.

The curriculum describes what trainees will know and be able to do upon completion of

training. In additions, methods of teaching and learning needed to deliver the curriculum

are outlined. The curriculum also describes in details, expectations from trainees during

their rotations in “The training rules and regulations section”. Methods of assessment and

examination regulations are also available in the last section of the curriculum.

All topics covered during practical and theoretical study are outlined in tables. This will

help trainees to guide their readings and their choice of learning activities. In addition, all

required activities and procedures are listed in the logbooks .

To help our trainers, supervisors and maximize benefits, we provided a guide for required

lectures and mandatory courses. The Egyptian Fellowship Board will work closely with

infection control scientific council to ensure proper organization and implementation of

courses at appropriate training stages.

We hope that all our trainees, trainers and educational supervisors will follow the guides

provided in the curriculum and cooperate with the Egyptian fellowship board and the in-

fection control scientific council to implement the curriculum in the best ways. Esmat Ahmed Sheba

Secretary General

Higher Committee of Medical Specialties

Acknowledgement

The infection control curriculum has been created through collaboration between The

Infection Control Scientific Council and The Egyptian Fellowship Curriculum Commit-

tee. The Egyptian Fellowship Board would like to acknowledge the efforts and the sub-

stantial contribution of the following council members who participated as subject mat-

ter experts in the curriculum planning and formulation

Professor Dr Osama Rasslan , Professor of medical microbiology and infec-

tion control, Ain Shams University and head of the infection control scien-

tific council

Dr Maha Mohammed Fathy, Associate professor of medical microbiology

and infection control, Ain Shams University

Dr Shereen Fawzy, Associate professor of medical microbiology and infec-

tion control, Ain Shams University

The Curriculum development was guided by consultation of experts working in

the field and benchmarking of internationally recognized societies’ guidelines

and curricula. The external references for the development of this curriculum

are:

1. The Royal College of pathologists for specialist training in medical microbiology and virol-

ogy

2. Infection Control guidelines of U.S. center for disease control and prevention (CDC)

3. The International Federation of Infection Control (IFIC)

4. The recommendations of Association for Professionals in Infection Control and epidemiol-

ogy (APIC)

5. Egyptian Fellowship guidelines for curriculum development

Rationale ……….……………………………………………………………………..….... 9

The Structure and Regulation of Infection Control Training…………………………… 10

Stages of Training and Learning………………………………………………………….. 13

Basics of Applied Medical Microbiology and Immunology…………………………...… 15

Prevention and Control of Health Associated Infections (HAIs)……………………….. 25

Module (1) Basic IC Principles and General Measures……..……………..…..…….. 26

Module (2) Applied Practices and Specific Measures……..……………….…………. 30

Methods of assessment…………………………...……...………………….……………… 34

Table of Contents………………

Infection Control Curriculum Egyptian Fellowship Board

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Rationale for curriculum development

I nfection Prevention and Control are essential components of quality

healthcare and patient safety. The development of the National Program

for infection prevention and control necessitates the existence of qualified

professionals who are guided by sound principles and current information.

The purpose of this training program is to ensure that trainees are fully prepared to

lead infection prevention and control services and are capable of developing, im-

plementing, supervising and auditing a comprehensive infection prevention and

control program in different healthcare facilities. In addition, the program will en-

sures that the trainees are able to achieve sufficient understanding of basics of ap-

plied medical microbiology and immunology to offer basic advice on relevant in-

vestigations of infectious diseases and interpretation of results. This training pro-

gram also guarantees that Infection Prevention and Control professionals are

alert to scientific literature and evidence based guidelines and they are capable of

working within the integrated programs of quality management and accreditation.

This curriculum is directed by the updated curriculum of the Royal College of

pathologist for specialist training in medical microbiology and virology and the

updated recommendations of Association for Professionals in Infection Control

and epidemiology (APIC). In Addition, the updated IC guidelines of U.S. centers

for disease control and prevention (CDC) and the International Federation of In-

fection Control (IFIC) are taken in consideration to ensure that the curriculum is

most up-to date as related to practice standards.


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The Egyptian Fellowship Board of Infection Control (IC) requires three years of

supervised training program that must be conducted in accredited training labora-

tory centers and hospitals before sitting for the final examination. This includes:

Supervised part time training in an accredited laboratory center for basic

microbiology and immunology (3 days per month for 8 months) before sitting

for the first part exam.

Part time hospital field supervised training must be conducted in one of the

accredited hospitals in the second stage of training (4 days per month for 25

months)

Full time supervised hospital field training (3 months) must be conducted

before sitting for the final exam.

Entry to the IC training program has the following requirements for trainees who are

affiliated to MOHP:

1. Graduation from medical school and successful completion of the preregistration

house officers' year.

2. Trainees, who finished their master/ M.D degree in microbiology and immunol-

ogy will join the program from the second stage of training and are exempted

from the first part exam. It is to be noted that this rule only applies for those who

gets the master/ M.D within five years. If more than five years passed, they must

sit for the first part exam.

The trainees will be rotated between two main accredited laboratory centers to ful-

fill the laboratory skills and procedures according to the curriculum and log book.

Trainees are expected to observe, assist in and interpret under supervision various

running and pre tailored laboratory experiences. Their attitude and performance will

be monitored and evaluated by trainers through check list and reported on monthly

basis for the Egyptian Fellowship Board and IC scientific council.

Basic microbiology and immunology training

The structure and regulations of infection control training


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Trainees will be promoted to this stage after basic microbiology training. During

this stage the trainees are expected to assist under supervision in planning,

implementing, supervising and auditing infection control practices in accredited

hospitals on part time basis according to log book of IC training. Required

assignments should be fulfilled in their hospitals on monthly basis. In the last three

months of training they should work on full time basis in a selected hospital.

1. Trainees must attend at least 75% of first part academic and practical activities

and fulfill (100%) of all activities and skills in the logbook before sitting for the

first part exam.

2. They should pass successfully through the first part Fellowship Exam before

being promoted to the final examination.

3. Trainees must attend at least 75% of second part academic and practical

activities and fulfill 100% of logbook of IC training, monthly assignments, and

the project before sitting for the final exam.

Trainees must pass successfully all the seven foundation courses

before being promoted to the second year of training. Full infor-

mation about foundation courses is available at the EF website and

administration office

Important notice

Infection Control training

Trainees duties and obligations


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1. The Logbooks

Two logbooks should be fulfilled, one for the basic microbiology training,

the second for IC training. The trainees must keep and update the Logbooks where

they record all activities and skills performed and learned during the training

program. The activities should be dated and categorized to whether been performed

by the trainee him/herself or as an assistant or participant. Each activity registered in

the Logbook should be counter signed by the trainer and finally the educational

supervisor. The trainer and educational supervisor shall sign the completed Log

Book.

It will be the place where the trainees will collect their monthly assignments to be

subject for discussion and assessment. The assignments will be evaluated on monthly

basis, and a final presentation and discussion will be done before sitting for the final

exam. The portfolio will also include the proof of attendance for scientific confer-

ences relevant to the practice of IC. Trainees should attend At least two confer-

ences during the period of training. In addition, trainees should prepare two

presentations on topics relevant to the practice of infection control. They should

present these activities for colleagues and trainers and keep record of them in their

portfolio.

An IC quality improvement project will be subjected to stepwise assessment and be

written and presented for final assessment before admission to the final examination.

It is not permissible to interrupt such a structural training program except in

major unavoidable circumstances. Such circumstances should be convincing and

approved by the Secretary General. The Interruption once approved should not be for

more than one year. Interruption of the training program for more than one year shall

result in dismissal from the program and cancellation of the preceding training

period. Interruption before completion of the first stage of training will require

repeating this stage once again.

2. The Reflective Portfolio

3. The project

Interruption of Training

Specific Requirements and Obligations


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There are 2 stages in the IC fellowship training program :

The first stage (8 months duration)

It provides trainees with a basic understanding of all aspects of medical microbiol-

ogy, and immunology and how it is applied to common IC and prevention problems.

The second stage (28 months duration)

It includes basic principles, applied practices, and advanced measures for prevention

and control of health care associated infections (HAIs).

The following teaching/learning methods will be used to facilitate the attainment of

the intended learning outcomes (ILOs).

A. Lectures

B. Seminars and Journal clubs

C. Practical session.

D. Observation of, assisting and discussion with senior medical staff.

E. Working under senior staff supervision.

F. Task specific on the job training.

G. Personal study.

H. Tailored practical experience.

I. Teaching other health practitioners.

J. Attending medical or scientific conferences.

The Capital letters will be used to denote which method of teaching and learning are

suitable for attainment of specific learning outcomes

Learning Methods

Stages of Training and Learning


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The numerical indicators for each assessment method appear on

the tabulated curriculum contents to indicate the types of assess-

ment that will be used to test the attainment of particular ILOs.

Continuous assessment throughout training will be undertaken by educational

supervisors and other senior members of staff. In addition to end stage assess-

ments (Part I , Part II & Part III).

a. Accurate and systematic observation by senior staff.

b. Correctly maintained and up-to-date logbook and portfolio.

c. Satisfactory trainer’s report.

d. Presentation at a seminar/lecture, journal club (keep record of presentation

handouts in portfolio).

e. Written assignments.

f. Project report & Presentation

g. Written examinations

h. Practical examinations

i. Oral examinassions

Assessment Methods

1- Methods of continuous assessment include:

2- End stage assessment

Subject for examination in

the first part exam

STAGE I

Basics of Applied Medical

Microbiology and Immunology


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The purpose of this course is to provide IC doctors with a systematic training in the

sciences relevant to IC which will enable them to provide, and take responsibility for

a broad-based infection control services.

By the end of this stage, the trainee should have adequate knowledge and deep un-

derstanding of:

1. Scientific basis of medical microbiology and immunology:

Trainees should elaborate the principles of the following, together with how they

may be applied to clinical and research problems:

Microbial classification

Morphology, culture, antigenic structure and virulence factors of microor-

ganisms of medical importance and the diseases they produce

Different types of host-parasite relationships

The epidemiology and pathophysiology of infectious disease process

Antimicrobial agents, their mode of action, adverse effects and mechanisms of

microbial resistance.

The immune response against infectious diseases.

Immune response disorders.

Principles of active and passive immunization.

Common immunologic/serologic tests

Specific problems related to opportunistic infection.

2. Laboratory safety.

Trainees should discuss the following:

Definition, etiology, modes of transmission and sources of laboratory ac-

quired infections

Classification of pathogens according to risk groups

Containment components

Bio safety levels

Other aspects of laboratory safety

Basics of Applied Medical

Microbiology &Immunology

Intended Learning Outcomes

A - Knowledge


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3. Sterilisation and Disinfection.

At the end of formal training, the trainee should outline the principles and uses of

sterilisation and disinfection procedures for the preparation of media and reproc-

essing of instruments.

4. Quality control

Trainees should explain the evidence base behind Standards of Practice (SOPs)

and the importance of internal and external quality control to establish validity in

microbiological laboratories.

5. Basics of Diagnostic microbiology

a- Handling of specimens :

Describe, for each specimen type, the optimal methods for collection, trans-

port (including transport media), storage, reception, identification and docu-

mentation, including the requirements for high-risk specimens.

Explain the utility of procedures for specimen collection relevant to infec-

tious diseases .

Highlight critical points in specimen processing where the continuity may fail

and be able to minimise the risk of this.

Describe, for environmental samples, the indication, optimal methods for col-

lection, transport (including transport media), storage, reception, identification

and documentation.

b- Microscopy :

Recall the principles of different types of microscopy and stains.

c- Culture methods :

Outline the basics of microbial growth requirements and culture.

d- Microbial Identification :

Define the principles of identification

Identify diagnostic techniques required in the practice of medical microbiol-

ogy

e- Typing Methods :

Describe the principles of available typing methods including serotyping,

pheno typing and genotyping; their advantages and limitations;

Recommend appropriate typing methods for clinical situations and interpret

the results.

Explain the role of different typing methods in incident/outbreak investiga-

tions.

List the available reference facilities for further identification and typing.


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f- Antimicrobial assays :

Discuss the following:

Current susceptibility methods for determining antimicrobial activity of

a drug

Techniques to determine concentration of antimicrobial agents in the

blood and other body fluids and their relationship to the therapeutic and

toxic effects on a patient

The use and limitations of the antibiogram for outbreak investigation

and control.

g- Advanced technologies :

Recall all major new technologies available in medical microbiology based on

molecular techniques and monoclonal antibodies

Recall different automated, rapid techniques available to medical microbiology.

By the end of first stage of training, trainees should be able to

Adhere to and comply with laboratory health and safety practice

Formulate a policy on the use of sterilisation and disinfection in the labora-

tory

Perform a risk assessment when required for all procedures undertaken in the

laboratory.

Find and implement national guidelines

Supervise collection, safe handling and processing of all routine specimens

received in the laboratory

Develop a sense of the continuity of identification of specimens from collec-

tion, through culture and further testing to the issuing of a final report.

Assess degrees of urgency for the processing of specimens, including the pro-

vision for an out-of-hours service and the communication of preliminary re-

sults as applicable;

Advice for further tests necessary for full identification of pathogens.

Recommend appropriate tests leading to the identification of all common

pathogens including the use of commercially produced kits (e.g. kits for en-

zyme assays) and rapid diagnostic kits (e.g. latex agglutination).

Recommend appropriate typing methods for clinical situations and interpret

the results.

B - Skills and Attitudes


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Assimilate clinical, laboratory and epidemiological information and use it to

differentiate between infections and other conditions.

Differentiate between infection, colonization and contamination.

Recognize the warning signs of immune disorders.

Achieve a specific or differential diagnosis.

Develop, under supervision, core reporting skills.

Offer basic advice on the interpretation of laboratory results.

Interpret the results of different antimicrobial susceptibility testing includ-

ing disc diffusion, MIC and MBC.

Provide clinical advice for the selection of the appropriate antimicrobial in

the clinical setting based on interpretation of susceptibility testing.

Interpret results of some serologic and antigen-based techniques.

Evaluate critically the need for emerging techniques within the laboratory

including cost effectiveness and effects on staffing levels and working

practices.

Recognize the indications for referral of specimens to reference facilities.

Provide informed advice on vaccination and immunisation with all products

normally available in Egypt.

Course Contents

Methods of Teaching & Learning

Methods of Assessment


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22

Medical Microbiology

Subject Learning

methods Assessment

Major Bacterial, Viral, and Fungal agents

1. Classification

2. Basic biology and general characters

3. Types of host-parasite relationships

4. Epidemiology, Pathogenesis, laboratory diagno-

sis and management of infections caused by:

Gram positive bacteria

Gram negative bacteria

Anaerobic bacteria

Mycobacteria

Atypical bacteria (Chlamydia, mycoplasma,

Rickettsia)

Enveloped &Non-enveloped DNA

viruses

Enveloped &Non-enveloped RNA

viruses

Hepatitis viruses

Oncogenic viruses

Slow viruses and Prions

Medically important fungi

A, C,,D,

G, H

a, b, c, g

Etiology, Epidemiology, Pathophysiology, labora-

tory diagnosis and management options of in-

fectious syndromes.

Urinary tract infection

Respiratory tract infection

Gastrointestinal infections

Skin and soft tissue infection

Encephalitis/Meningitis

Deep infection (e.g. septicemia, endocarditis,

bone infection)

Genitourinary tract, sexually transmitted infec-

tions (STIs).

Infections in pregnancy. Methods of diagnosis,

and implications of infection for mother and fetus

A, C,,D,

G, H a ,b ,c ,g

Antimicrobial and Antifungal therapy:

Classification

Mechanism of action

Therapeutic and prophylactic uses

Adverse effects and complications

Mechanisms for development of resistance

Classification and Principles of action of Antiviral

drugs.

A, C,,D,

G, H a ,b ,c ,g


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23

BASIC IMMUNOLOGY

Subject Learning

methods

Assessment

Innate and acquired immune response (IR)

Immune response to various infections

The role of host response in immunopathology.

Vaccines and schedules of immunization.

Hypersensitivity reactions

Primary and secondary immune deficiency diseases

Immunosuppressives and Immunomodulators

Antigen- Antibody based serodiagnostic tests

Tests for assessment of immune response

A, C,,D,

G, H a ,b ,c ,g

Infection in immunocompromised hosts:

Pathophysiology of infection in immunocompro-

mised hosts.

Clinical and laboratory manifestations of immunode-

ficiency.

LABORATORY ASPECTS OF MICROBIOLOGY

Subject Learning

methods Assessment

Standards of Practice:

Good laboratory practice.

SOPs

Audit and quality control for validity

A, C,,D,

G, H

a ,b ,c ,g

Basic principles of diagnostic microbiology:

Sample collection and processing (Clinical &

Environmental)

Staining and culture techniques

Sterile and contaminated/colonized body sites

Diagnostic and Identification tests of common

bacterial pathogens.

Serologic and antigen-based diagnostic techniques

(latex agglutination, ELISA, immunofluorescence,

CFT, RIA ,….)

Molecular diagnostic techniques including PCR

(including real-time), RT-PCR, and sequencing,

interpretation, appropriateness, advantages and

limitations.

Automated and semi-automated methodologies in

microbiology


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24

Subject Learning

methods Assessment

Laboratory acquired infections

Definition & Etiology

Modes of transmission

Sources& Routes

Equipment-related hazards

A,

B,C,D,E,F

,G, H, I, J

a ,b ,c ,g ,h,i

Classification of pathogens according to risk

groups

Containment

Definition

Methods and Levels of containment

Biosafety

Definitions of biohazards

Levels of Biosafety

Components of each level

Other aspects of laboratory safety

Physical

Chemical

Antimicrobial susceptibility testing:

Techniques for susceptibility testing (Disc diffusion, E-

test, broth dilution and automated methodologies) and in-

terpretation of the results.

The use and limitations of anti biogram for outbreak inves-

tigation and control.

Basic principles of drug monitoring and its uses.

A, C,,D,

G, H

a ,b ,c ,

g

Typing methods:

Biotyping methods.

Serotyping methods.

Anti biogram

Phage typing

Colicin typing

Genotypic methods.

Others

Indications for referral of specimens to reference facilities.

LABORATORY SAFETY

STAGE 2

Prevention and Control of

Health Associated Infections

(HAIs)


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26

Module (1)

Basic IC Principles and General Measures


A - Knowledge:

This module provides the trainee with the broad knowledge & deep understanding of:

1. Basic concepts of IC.

2. Risk factors for nosocomial infection transmission.

3. Definitions of HAIs.

4. Epidemiological aspects of HAIs.

5. IC program planning and resource allocation.

6. IC program management, communication and feedback.

7. Organizational structure and job description for IC positions.

8. Surveillance strategies of nosocomial infections.

9. Use of statistics in infection control.

10. Outbreak investigations

11. IC aspects of occupational health and safety.

12. Strategies & evidence based guidelines for standard & general IC measures.

13. Strategies for isolation precautions and appropriate patient placement.

14. Antimicrobial stewardship and how to combat resistance.

15. The audit cycle and interaction with surveillance cycles.

16. Performance indicators and quality improvement.

17. Role of IC in total quality management of healthcare facilities.

18. Patient safety.

19. Principles of adult learning and training.

By the end of training, trainees should be able to:

1. Assess infection risk and develop infection prevention and control strategies.

2. Develop and recommend IC policies and procedures.

3. Assess the educational needs of health care workers regarding IC.

4. Conduct infection control educational and training programs for healthcare

workers and non medical care givers.

B - Skills and attitudes


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27

5. Use different media for teaching that are appropriate to the teaching setting.

6. Communicate effectively with learners

7. Conduct infection prevention awareness programs for patients and visitors.

8. Apply clinical and microbiological parameters for identification of HAIs.

9. Develop surveillance and referral forms to collect appropriate data.

10. Select indicators based on the projected use of the data.

11. Perform surveillance studies using risk stratification.

12. Use a systematic approach for data collection, recording, analysis and inter-

pretation.

13. Develop and compare infection rates.

14. Collaborate with appropriate persons to establish the existence of an out

break.

15. Formulate hypothesis on outbreak source and mode of transmission.

16. Institute and evaluate control measures for outbreaks.

17. Initiate and discontinue isolation precautions when indicated.

18. Advise on appropriate patient placement.

19. Prepare final written reports.

20. Develop, evaluate, and revise a written mission statement, goals, measur-

able objectives, and action plans for an Infection Control Program.

21. Recommend specific equipment, personnel, and resources for an Infection

Control Program

22. Experience the practice of audit through evaluating the structure, processes

and outcomes against the standards according to evidence based IC guide-

lines.

23. Perform an infection-control oriented risk assessment for all procedures

undertaken in the hospital, including the laboratory and for all categories of

workers, including the pregnant and immuno-compromised.

24. Identify opportunities for improvement based on indicators, process and

outcome measures, other findings, or observations.

25. Participate in multidisciplinary quality/performance improvement strate-

gies.

26. Demonstrate awareness of patient safety in a practical situation.


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28

Subject Learning

Methods

Assessment

Methods

Basic concepts of IC, misbelieves and misconceptions

A, B, G, J

g, h ,i

Risk factors for nosocomial infection transmission

Epidemiological aspects of HAIs

CDC definitions of HAIs.

IC program components and management

Organizational structure for IC

The roles and responsibilities of the infection control

team and committee

Surveillance:

Design of Surveillance Systems.

Collection of Surveillance Data.

Compiling Surveillance Data.

Interpretation of Surveillance Data

A,B,C,D,E,

F,H

a, b, c, d, e,

g, h, i

Outbreak investigations:

Identification of an outbreak

Planning the investigation and development of an

outbreak team

Developing a data collecting form: including:

demographic characteristics, clinical data and any

other potentially relevant data

Describing the outbreak

Suggesting and testing a hypothesis

Control measures and follow –up

Communication and final reporting

A,B,C,D,E,

F,H

Occupational health and safety A,C,F,H

Module Contents


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29

a, b, c, d, e,

g, h, i

Standard and general IC measures:

Hand hygiene and antisepsis.

Personal protective equipment (PPE).

Cleaning, disinfection and sterilization.

Aseptic techniques.

Waste management.

Environmental services.

A,B,C,D.

E,F,G,H,I

,J

Isolation precautions:

Standard precautions

Transmission based precautions

A,B,C,D,

E,F,G,H,I

,J

Antimicrobial stewardship:

Rational use of antimicrobials

Clinical use of antibiotics for therapy and prophylaxis.

Antibiotic resistance: reservoirs and how to prevent.

Antibiotic policy.

Role of microbiology lab.

A,B,C,D,

E,F,G,H,I

,J

Education and adult learning:

Adult learning principles

Learner needs.

Structure of a teaching activity.

Varied teaching strategies.

Learning styles.

Principles of evaluation.

A,B,H,I

Auditing:

The audit cycle components

The audit cycle and interaction with surveillance cy-

cles

A,E,F,H

Quality concepts of IC:

Coordination of quality/performance improvement

activities related to infection control

Quality/performance improvement projects

The use of graphic tools (e.g., “fishbone” diagram,

Pareto charts, flow charts)

A,C,F,G,J

Patient safety

A,B,C,D,

E,F,G,H,I

,J

Subject Learning

Methods

Assessment

Methods


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30


A - Knowledge:

This module provides the trainee with the broad knowledge & deep understand-

ing of:

1. IC strategies for specific patient care settings (e.g., nursing unit, intensive care

unit, operating room, dentistry unit, dialysis units and burn unit).

2. IC measures to reduce infection risks associated with therapeutic and diagnos-

tic procedures and devices (e.g., intravascular devices, urinary catheters, bron-

choscopy, endoscopy and angiography).

3. IC measures for out-patient health care settings (e.g., ambulatory care, home

care and doctor’s office).

4. IC guidelines for support services (e.g. laundry, kitchen, respiratory care, im-

aging services and radiation oncology).

5. Environment care IC issues (engineering and maintenance, heating, ventila-

tion, and air conditioning, water issues, construction and renovation, postmor-

tem care).

6. Epidemiology and control of common and important multi-drug resistant or-

ganisms.

7. Advanced occupational safety issues.

8. Regulatory standards for obtaining and maintaining accreditation of health-

care facilities.

9. The roles and responsibilities of team members, especially within the depart-

ment and within multidisciplinary teams and how a team works effectively.

10.Socio-economic aspects of HAIs.

11.Medico-legal aspects of hospital acquired infections.

12.Interaction between community and hospitals

13.Global impact of IC.

14.The methods needed for Planning and designing of research studies.

Module (2)

Applied Practices and Specific Measures


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31

By the end of training, trainees should be able to:

1. Implement evidence based IC guidelines for specific patient care settings,

risky procedures, and common HAIs.

2. Evaluate patient care environments for infection control practices and haz-

ards

3. Participate in antimicrobial monitoring and evaluation.

4. Implement a multi-component Multi-Drug resistant Organisms (MDRO)

control program appropriate for the prevalence of MDROs and the risk of

transmission and adverse outcomes.

5. Develop screening programs for health care workers.

6. Collaborate on immunization programs for health care workers.

7. Investigate and follow-up health care workers exposed to communicable

diseases.

8. Recommend level of work restriction for health care workers with communi-

cable diseases.

9. Provide counseling to health care workers exposed to a communicable dis-

ease.

10. Assess risk of occupational exposure to infectious diseases by job classifica-

tion or department (e.g., TB, blood borne pathogens)

11. Assist with analysis and trending of occupational exposure incidents.

12. Measure compliance with regulations and standards.

13. Assist in obtaining and maintaining accreditation.

14. Communicate with other members of the multidisciplinary team

15. Show leadership and safe supervision.

16. Provide a high quality service in a cost effective manner.

17. Serve as a public educator on infectious illness topics to individuals and

groups in the community.

18. Participate in research activities.

19. Acquire the lifelong habits of reading, literature searches, consultation with

colleagues, attendance of scientific meetings and presentation of scientific

works that are essential for continuing professional development.

B - Skills and attitudes


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32

Subject Learning

Methods

Assessment

Methods

IC for specific patient care settings:

Intensive care unit

Neonatal intensive care unit

Operating room

Burn unit

Dentistry unit

Renal dialysis units

Endoscopy unit

Cardiac catheterization

Imaging services & radiation

Radiation oncology

Respiratory care

Post mortem care

Safe injection

A,B,C,D,E

,F,G,H,I,J

a, b, c, d, e,

j, h, i

Prevention of procedure/device related infections:

Urinary catheter related infections

Intravascular device related infections

Surgical site related infections

Ventilator associated pneumonia

A,B,C,D,E

,F,G,H,I.J

IC measures for out-patient health care settings:

Ambulatory care

Home care

Long term care

Doctor’s office

A,B,C,

D,E,F,

G,H,I,

J

IC guidelines for support services:

Laundry

kitchen

A,B,C,

D,E,F,

G,H,I,

J

Environment care IC issues:

Ventilation requirements in hospitals

Hospital water requirements and quality

Construction

Maintenance and engineering

A,B,C,

D,E,F,

G,H,I,

J

Module Contents


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33

Subjects Learning

Methods

Assessment

Methods

a, b, c, d, e,

j, h, i

IC strategies for multi-drug resistant organisms:

Methicillin -resistant Staphylococcus aureus

Glycopeptide-resistant enterococci

ESβL producing Gram negative bacilli

Clostridium difficile.

MDR mycobacteria

A,B,C,D,

E,F,G,H,I

,J

Advanced occupational safety issues:

Screening programs for health care workers

Adult immunization programs

Work restrictions

Local, national and international guidelines and

standards in relation to occupational exposure

to infection

Needlestick incident management follow-up for

health care workers

The ethical implications of blood-borne viruses

for health care workers

The role of counseling.

A,B,C,D,

E,F,G,H,I

,J

Accreditation of health care facilities A,B,F,G,J

Communication skills and leadership A,B,C,D,E,I

Socio-economic aspects of HAIs. A,B,EF,G,HJ

Medico-legal aspects of hospital acquired

infections.

A,D,E,F,G,H,

I,J

Interaction between community and hospitals B,F,G,H,I,J

Research activities:

The principles of performing a research study.

The principles of research ethics

Appropriate statistical methods.

How to write a scientific paper.

A,B,C,D,E,F,

G,H,I,J

Continuing professional development.

A,B,C,D,E,F,

G,H,I,J


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Methods of assessment

The general rules and regulations of assessment approved by the Egyptian fellowship

board and published at the training handbook and at the board web site applies for

the infection control specialty. In addition to the successful completion of the

training program, all candidates must successfully pass three exams in order to get

the fellowship certificate.

The first part exam is a written exam. Trainees are allowed to sit for the first part

exam after at least eight months of training. Each candidate has three chances to pass

the exam and one more additional chance may be granted in some special

circumstances approved by the secretary general of the higher committee of medical

specialties. It is to be noted that after one year of training each time the candidate

choose not to enter the exam will be calculated as one of his three attempts

The second part exam is a written exam. Trainees are allowed to sit for the second

part exam after passing successfully the first part and after completion of the training

period (three years). In addition, each candidate must submit his infection control

logbook and reflective portfolio and project for final assessment. The logbook re-

quirements must all be completed and signed by the trainer and educational supervi-

sor. The log book, portfolio and the project must be accepted by the scientific coun-

cil and the trainee must make an oral presentation about his project.

- Trainees should pass the following courses in order to be eli-

gible for the first part exam: Local TOEFEL with a score of at least 500

Computer courses in word processing, power point and

internet

- In addition, their basic microbiology logbook must be submit-

ted for and accepted by the infection control scientific council.

Regulations

First part Exam

Second part exam

Pre-requisites for entering the first part exam


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35

Practical and final Exam (third part)

The third part exam is a practical and oral exam. Candidates who pass success-

fully the second part are allowed to sit for the third part. Again, each candidate

has three chances to pass this exam and an additional fourth chance may be

granted in special approved circumstances.

The first part exam aims to test trainee's knowledge and problem solving skills

in basic microbiology and immunology module of their curriculum.

The structure of the first part exam

PART I examination consists of two papers:

1. Paper I (2 hours): Multiple choice questions with a single best answer for-

mat. This paper will cover the knowledge of basic microbiology and im-

munology.

2. Paper II (2 hours): short answer and /or MCQ questions and this paper test

trainees' problem solving skills in basic microbiology and immunology.

aims to test trainees' knowledge and skills in infection control. In this

exam infection control modules will be covered .

The structure of the second part exam:

Part II examination consists of four papers:

- First MCQ paper: the duration is two hours. It tests trainees' knowledge

in infection control principles. Trainees will choose one best answer in

each question

- First assay paper: the duration is two hours. It tests trainees' problem

solving abilities in basic infection control through case studies and situa-

tion analysis

- Second MCQ paper: the duration is two hours. It tests trainees' knowl-

edge in module two of the infection control curriculum. Trainees will

choose one best answer in each question

- Second assay paper: the duration is two hours. It tests trainees' problem

solving abilities in module two of the infection control curriculum

through case studies and situation analysis

The structure of the examination

First part Exam

The second part exam


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The structure of the third part exam:

part III exam is a Practical and oral exam and is composed of the following compo-

nents:

OSPE: The objective structured practical exam is a multiple station examina-

tion (10-12 stations) including audit stations, procedural stations, videos, coun-

seling and communication skills, laboratory data reports and simulated scenar-

ios. The candidate rotates from station to station where he / she are tested on

specific elements that measure different skills stated in the curriculum

VIVA: The oral exam is based on a set of topics that covers the curriculum.

Each oral station is composed of opening and supplementary questions. The

questions’ cards are prepared in advance together with the expected ideal an-

swer and allocated marks. This allows good objective basis for marking. The

candidate usually rotate through three oral committees, each committee is

composed of two examiners and cover two Infection control domains. The

duration of each examination is 10 minutes with a total of 60 minutes for the

whole oral exam

Third part Exam


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Egyptian Fellowship Board Infection Control Curriculum…كافحة العدوي... · and...

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