Infection Prevention: A Job for Everyone

Jennifer La Grassa

In the United States, 1 in every 25 patients acquires a healthcare associated infection (HAI) on any given day. A 2011 report, published by the Centres for Disease Control and Prevention (CDC) found that 722,000 patients in acute care hospitals acquire HAIs, and annual associated costs are estimated to be between 28 and 45 billion dollars.

Common sources of HAIs include patients themselves, medical equipment, healthcare workers, the hospital environment and contaminated drugs or food.

Healthcare facilities with educated staff practising essential precautionary measures can see some HAIs decrease by up to 70 percent. But while many HAIs are preventable, rates are on the rise.

A job for more than Infection Preventionists

Infection prevention and control teams (IPC) are at the forefront of essential programming, educational workshops, surveillance and data extraction and analysis when it comes to HAIs.

However, rising rates of HAIs have garnered the attention of regulatory bodies and academics, which has led to more regulations for IPCs to follow. In 1981, the Association for Professionals in Infection Control and Epidemiology (APIC), found that the number of tasks performed by professionals on infection prevention teams averaged 60. In 2009, that number had increased to 147.

The work of managing and preventing infections is an organisation-wide priority – and one that’s success depends on a collaborative effort by all staff.

For this year’s International Infection Prevention Week, the focus is on shifting the mindset that infection prevention is the responsibility of a few, dedicated individuals and putting the focus on the role all staff play in IPC work.

Making this transition requires effort and persistence on the part of IPC teams. Adjusting mindsets and behaviours may require administrative enforcement, structural redesign and adopting a new organisational culture.

Some places to start:

Leadership

Appointing people throughout the organisation that will help underscore the message and initiatives of IPC teams to all levels of the organisation is essential. Healthcare organisations should strive to have administrators, directors and individual healthcare personnel be advocates for risk reduction. Creating these multiple touchpoints for staff, makes information easier to access and can help translate values into behaviour.

The four main roles of infection leaders can include:

  1. Cultivating a culture of high clinical standards and safety that is communicated to staff
  2. Assisting others in overcoming barriers that pose a challenge to effective HAI strategies
  3. Acting as role models for staff
  4. Strategic thinking on a local and cross-organisational level

Coalition Building and Collaborative Work

Collaboration across the organisation brings together a range of perspectives on infection prevention and creates an open-dialogue that can lead to new programs or initiatives. It begins with breaking down the siloed mentalities and boundaries between teams and groups. The potential results? More successful antimicrobial stewardship programs that draw upon a diverse group of individuals that can apply surveillance methods, education, analysis, data collection, prevalence reports and auditing. Plus, opening the floor to staff with varying backgrounds or levels of authority can help energise projects and ensure they make it from “ideas” to “implementation.”

Implementing Robust Support Systems

Technology has a role to play in healthcare settings by increasing efficiency and automating some processes associated with infection prevention. Between reporting and tracking HAIs, having a system in place that is user-friendly and adaptable to your organisation’s culture of safety can make processes easier and quicker for staff.

Making Simple Changes for Greater Impact

Changing staff mindsets to include everyone in infection prevention is not an easy task. One way is to start simple – creating greater emphasis and involvement in IPC initiatives and focuses that lend themselves well to organisation-wide collaboration.

Some examples include:

  1. Environmental Cleanliness: hospital surfaces, tools and materials are one of the most common sources of HAIs. Environmental cleanliness takes a collaborative effort – making it an easy focus for frontline staff engagement.
  2. Hand Hygiene: It’s simple but effective. Good hand hygiene is recognised as one of the most effective and important prevention methods for HAIs, but adherence rates only average about 40 percent. Hand hygiene often fails when organisations are understaffed or experiencing crowding. Focusing on hand hygiene adherence and ensuring manageable workloads can help make this practice stick.
  3. Antimicrobial Stewardship: Developing an antimicrobial stewardship program is complex. Considerations include supplying education around antibiotic usage, maintaining a surveillance system for patients that have acquired antimicrobial-resistance pathogens and implementing strong infection control programs to limit their spread. Given the number of factors these programs must consider, they often benefit from multidisciplinary team members being involved in the process.

Looking Forward

Engaging members of a healthcare organisation to place infection prevention measures at the forefront of the agenda, requires heterogeneous approaches, as no two facilities are alike in their values, mandate, and culture.

Organisation’s that have begun to take a collective approach towards infection prevention cite robust infection prevention methods, encouraging staff to adhere to infection programs, and breaking down those silos to promote collaboration.

It will guide them in going beyond education and utilising methods that will not only encourage behaviour change but enforce it.

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