Certification is Key in Preventing Infections, Advancing Careers

By Elizabeth Srejic

On any given day approximately 1 in 25 patients contracts at least one healthcare-associated infection (HAI) in a hospital or other healthcare setting.¹ Lowering the incidence of HAI could potentially reduce a multitude of steep human and financial costs -- namely  illness, disability, mortality and billions of dollars in unnecessary healthcare expenses.^2-3 Healthcare organizations, healthcare workers (HCWs), patients and other stakeholders look to infection preventionists (IPs) to tackle the problem of HAI in healthcare facilities. In meeting this challenge, IPs must rely upon their education, skills, training and experience. Becoming certified is one of the leading ways that IPs can formally demonstrate that they are committed to maintaining strong competencies, immersing themselves in the latest implementation science and providing quality leadership.

IPs can earn the CIC® credential, currently the only recognized professional certification for IPs, by passing an examination administered by the Certification Board of Infection Control and Epidemiology, Inc. (CBIC), an organization founded in 1981 by the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC) to develop, administer and promote an accredited certification program for competent IPs. CBIC, which is accredited by the National Commission for Certifying Agencies, identifies itself as an independent, voluntary, autonomous, multidisciplinary board dedicated to protecting the public by providing a standardized measurement of competency in the infection prevention and control profession. According to CBIC, the CIC® credential is currently held by more than 5,800 individuals working in a variety of healthcare settings worldwide who are responsible for developing, implementing and analyzing strategies to fight HAI and educating HCWs and the public on infection prevention and control.

Experts have called the CIC® credential the most recognized and accepted standard in the field of infection prevention and control and an important way to identify healthcare professionals who have demonstrated mastery of knowledge in the profession.⁴  One such expert, Carol McLay, DrPH, MPH, RN, CIC, an infection prevention consultant, says that beyond these benefits, certification provides IPs with an objective means to develop their careers.

"The field of infection prevention and control is expanding rapidly and the current Ebola crisis in West Africa is drawing attention to the role of IPs and will result in higher demand for competent professionals," she says. "Professional development is critical to keep knowledge and skills current in order to enhance your facility’s infection prevention and control program and provide the safest patient care possible. The CIC® credential shows a commitment to best practices in infection prevention and control and improved patient care and signals to your employer and colleagues that you are committed to your professional growth and obtaining and maintaining certification is one of the most important contributions you can make to the advancement of the field.”

According to CBIC, passing the CIC® examination requires mastery of six core competencies or major content areas including identification of infectious disease processes, surveillance and epidemiologic investigation, preventing/controlling the transmission of infectious agents, employee/occupational health, management and communication (leadership), and education and research. According to a report, CBIC determines these core competencies based upon a body of common knowledge derived from periodic, scientific analysis of real-world practice in the infection prevention and control profession within the United States and Canada and the CIC® examination measures the test-taker’s knowledge against this body of common knowledge.⁵

In order to earn eligibility to take the CIC® examination, candidates must fulfill certain practice and education requirements. For example, they must have a minimum of two years practice in infection control with a minimum of 800 hours worked prior to the date of the examination and hold a current license or registration as a medical technologist, physician or registered nurse. They must also possess a minimum of a baccalaureate degree although CBIC states this can be waived in some cases. To maintain the CIC® credential, the infection prevention and control professional must retake and pass the examination every five calendar years.

APIC offers a number of educational resources and member networks to assist candidates taking the CIC® examination for the first time or recertifying. One of these resources is a study guide designed to prepare candidates for the examination.⁶ The fifth edition of this study guide, released in late 2014, contains 630 practice questions covering areas of content identified by CBIC as well as practice tests that simulate the test experience.

“I would definitely recommend the Certification Study Guide to help candidates prepare for the CIC exam,” says McLay, author of the fifth edition of the study guide.  “We have completely redesigned the study guide and have included new practice questions that review the six content areas identified by the CBIC practice analysis. In addition there are three full-length practice exams with rationales and references for every question. Test-taking tips and chapter-by-chapter guidance on optimal ways to study and succeed make the book a must-have for those seeking certification.”

According to published peer-reviewed research, certified individuals regardless of their educational background tend to outperform their noncertified counterparts in terms of reduced infection rates and other encouraging outcomes.⁷ For example, multiple studies authored by Krein, et al. reported that certified IPs may be better prepared to use quantitative and qualitative research in, and successfully drive the implementation of, infection control practices, and act as champions of patient safety in their organizations.^8-10

McLay agrees with the findings of these and similar studies: "There are indications that certified individuals outperform their noncertified counterparts," she says. "A 2013 study found that IPs with the CIC® credential are two to three times more likely to perceive the evidence behind certain infection prevention practices as strong, compared to their non-certified peers.¹¹  In further support of this statement, hospitals whose infection prevention and control programs are led by CIC® have significantly lower rates of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections than those that are not led by a certified professional.“¹²

Fortunately for those pursuing careers in infection prevention and control, experts say that the field has never been as publically recognized and appreciated, nationally and internationally, as it is today.¹³ One of these experts is McLay, who connects recent high-profile infectious disease crises to the widespread increased acknowledgement of the profession's importance.

"Over the last decade or so, outbreaks of antimicrobial resistant organisms such as MRSA, SARs, MERS and most recently Ebola have really catapulted infection prevention into the limelight of public attention," she says. "My hope is that this will result in increased funding to the public health infrastructure and more specifically, infection prevention and control departments that have been underfunded and under-appreciated for so long."

Beyond improving the IP's ability to address challenges in modern infection control, validate competency to lead, and demonstrate commitment to the profession, colleagues, patients, and facility,¹⁴ McLay says another compelling reason to get certified is that employers are increasingly looking for credentialed IPs. "In the future, I believe that the CIC® credential will become the minimum standard for employment in the field of infection prevention," she says.  "Patients deserve a safe and infection-free healthcare experience and the CIC® credential demonstrates the IP’s commitment to best practices and professional growth. Given the choice, wouldn’t you hire an IP with the CIC® credential?"

For more information, visit www.cbic.org and www.apic.org.

Elizabeth Srejic is a freelance writer for ICT.

References
1. “The Direct Medical costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention.” Scott II, R. Douglas. March 1, 2009. Accessed December 10, 2014. http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf
2. Ibid.
3. Magill SS, Edwards JR, Bamberg W, et al. Multistate Point-Prevalence Survey of Health Care–Associated Infections. N Engl J Med 2014;370:1198-208.
4. Pirwitz S. The Certification Board of Infection Control, Inc. Infect Control Hosp Epidemiol. 1995 Sep;16(9):518-21.
5. Crist KS, Russell BS, Farber MR. The value of certification and the CIC credential. Am J Infect Control. 2012 May;40(4):294-5.
6. "Certification." Association for Professionals in Infection Control and Epidemiology (APIC). January 1, 2014. Accessed December 10, 2014. http://www.apic.org/Education-and-Events/Certification.
7. Crist KS, Russell BS, Farber MR. The value of certification and the CIC credential. Am J Infect Control. 2012 May;40(4):294-5.
8. Saint S, Kowalski CP, Banaszak-Holl J, Forman J, Damschroder L, Krein SL. The importance of leadership in preventing healthcare-associated infection: results of a multisite qualitative study.Infect Control Hosp Epidemiol. 2010 Sep;31(9):901-7.
9. Damschroder LJ, Banaszak-Holl J, Kowalski CP, Forman J, Saint S, Krein SL. The role of the champion in infection prevention: results from a multisite qualitative study. Qual Saf Health Care. 2009 Dec;18(6):434-40.
10. Forman J, Creswell JW, Damschroder L, Kowalski CP, Krein SL. Qualitative research methods: key features and insights gained from use in infection prevention research. Am J Infect Control. 2008 Dec;36(10):764-71.
11. Saint S, Greene MT, Olmsted RN, Chopra V, Meddings J, Safdar N, Krein SL. Perceived strength of evidence supporting practices to prevent health care-associated infection: results from a national survey of infection prevention personnel. Am J Infect Control. 2013 Feb;41(2):100-6.
12. Pogorzelska M, Stone PW, Larson EL. Certification in infection control matters: Impact of infection control department characteristics and policies on rates of multidrug-resistant infections. Am J Infect Control. 2012 Mar;40(2):96-101.
13. Crist KS, Russell BS, Farber MR. The value of certification and the CIC credential. Am J Infect Control. 2012 May;40(4):294-5.
14. Ibid.