Patti Grant -- 29th Annual TSICP Conference 2006

Infection Control & PreventionA generic overview of an

How Does Infection Prevention & Control fit into

“The Big Picture” of our healthcare facility?

Patti Grant -- 29th Annual TSICP Conference 2006

Infection Control (Epidemiology) The Study of Infection Control (IC) is

grounded in “Epidemiology”

Epidemiology: The Study of Anything that happens to people

EPI – Upon DEMOS – People LOGY -- Study

Patti Grant -- 29th Annual TSICP Conference 2006

Where Did IC Come From? Where is IC Prevention Going? 1840’s with Dr. Semmelweis

Handwashing Germ Theory Cemented 1930’s Late 1950’s Antibiotics Early 1960’s Antibiotic Resistance

Back to Handwashing & Prevention 1970: 1st isolation guideline published by

CDC 1992: HICPAC formed to advise DHHS/CDC

on infection prevention in healthcare facilities and develop guidelines

Today: Travel, Bioterrorism, Super Bugs, Community Participation

Patti Grant -- 29th Annual TSICP Conference 2006

We’re Called Many Things … Even if we “just do” Infection Control

Nurse Epidemiologist Infection Control Practitioner Infection Control Professional Infection Control Coordinator Infection Control Manager Infection Control Director

Patti Grant -- 29th Annual TSICP Conference 2006

We Work Many Places … Resources are Varied Large University Teaching Hospital Non-Teaching Acute Care For Profit Non-Profit Medium & Small Hospitals Non-Traditional Settings “Hospital” vs. “Free-Standing” non-hospital

affiliated healthcare facilities

Patti Grant -- 29th Annual TSICP Conference 2006

Non-Traditional ICP Settings affiliated with Hospitals Ambulatory Clinics Day Surgery Centers Long Term Care Facilities Rehabilitation Services Home Care Dialysis Centers Transitional Care Physicians Offices

Patti Grant -- 29th Annual TSICP Conference 2006

Setting Determines Resources Educational Sponsorship? Hardware? Software? Data Entry & Secretary Support? Number “dedicated” to IC & P? Non Revenue-Producing Department

Multiple Hats? Risk Management, Employee Health, Nurse

Educator, Quality Management, Utilization Review

Patti Grant -- 29th Annual TSICP Conference 2006

How is an ICP “Born” ? APIC -- 1972 LVN, RN, MT, MPH Formal Training

APIC & State IC Organizations 1-3 years to become ‘proficient’ Ongoing Education

CIC -- 1983 Giving Back: Sustaining the Profession

Research and Publications Volunteerism Involvement with Public Policy

Patti Grant -- 29th Annual TSICP Conference 2006

Infection Control Human and Fiscal Resources SENIC Study 19851: ratio of number of ICPs to patient

beds 1:250 Acute Care Before advent of clinics and off-site services, and extensive

diversity & complexity of services Delphi Study 20022: ratio 1:100 (response to expanded

responsibilities) CBIC task analyses of ICP job every 5 years 1982-2002 Infrastructure consensus recommendations 1998,19993 These studies assume “Dedicated ICP” and not a “multi-

tasker” (wearing many hats)

1 Haley RW. Am J Epidemiol 1985; 121: 1822 O’Boyle C. AJIC 2001; 30:3213 Scheckler WE. ICHE 1998; 19:114; Friedman C. ICHE 1999; 20: 695

Patti Grant -- 29th Annual TSICP Conference 2006

Not “JUST” Infection Control Microbiology Epidemiology Statistics Management Communications Employee Health Reportable Disease Plant Operations

Education Sterilization Disinfection Patient Care Infectious Disease Research Projects Vendor Decisions Construction &

Renovation Projects

Patti Grant -- 29th Annual TSICP Conference 2006

Any IC Decision is Multifaceted APIC & SHEA CDC … Can I take my JCAHO placenta home? EPA … Can I get AIDS from OSHA a razor blade that FDA was in a shoe at the store? CMS … What refrigerator can I store leeches in? State & Local Health Department

Patti Grant -- 29th Annual TSICP Conference 2006

In a Nutshell? Infection Control: Conductor of Biohazard Safety

For Patient, Employee, Volunteer, Visitor Discussion Conclusion Recommendation Action Follow-Up

Patti Grant -- 29th Annual TSICP Conference 2006

Infection Control: The Big Picture

Site Visits (Surveillance Rounds)

Prospective Chart Surveillance

Policy & Procedure

Information Sharing

Patti Grant -- 29th Annual TSICP Conference 2006

Examples of “Big Picture” …

September 11, 2001 Bioterrorism Preparedness Smallpox Vaccine Anthrax Ricin

Monkey pox – For Real!

SARS

2004-2005 Flu Vaccine Shortage

Patti Grant -- 29th Annual TSICP Conference 2006

Our Public Health Commitment Extends beyond the hospital

TB Elimination Meningococcal meningitis Enteric Pathogens Emerging Diseases (SARS)

The “OUTSIDE” does and will come in …it is not just business as usual

Patti Grant -- 29th Annual TSICP Conference 2006