Despite Little Interaction With Patients, IPs Play Huge Role in Keeping Them Safe

Patient Safety Awareness Week runs from March 13 to March 19 this year, but infection preventionists (IPs) keep patient safety in mind all year round. Andrea Blyth-Cheggour, BSN, RN, CIC, is the director of infection prevention at Tallahassee Memorial Hospital. “One of my main duties in keeping patients safe is performing regular hand hygiene observations,” she tells Infection Control Today® (ICT®). “Our IP team converses with all nursing units daily to ensure any required transmission-based precautions are in place as well as answer any questions or concerns.”

While they do regular rounds, Blyth-Cheggour says IPs also audit all indwelling devices, such as catheters and central lines, and IPs will also advocate for early removal of the lines to avoid infection. “I’m a member of a patient safety committee, which meets bimonthly bringing various service line leaders around the table to show how we’re keeping our patients safe,” Blyth-Cheggour says.

IPs know they are doing their job when they walk into a unit and hear, “Oh no, here she/he comes again.” Every IP knows this means the staff know who they are and that they are looking for flaws in infection prevention practices.

The backgrounds for the majority of individuals who practice as IPs are as follows:

Source: Linda Spaulding, RN-BC, CIC, CHEC, CHOP

The data were collected from a 2017 mega-survey by the Association for Professionals in Infection Control and Epidemiology (APIC). A study in the American Journal of Infection Control, an APIC publication, says 4079 of 13,050 active APIC members (31%) participated in the survey.

According to the data, the primary job activity for IPs with a nursing background (97.9%; n = 2434) is preventing and controlling the transmission of infectious agents or health care–associated infections. For IPs who previously worked as laboratory scientists (97.5%; n = 307), it is the interpretation of surveillance data. For IPs with a public health background (96.1%; n = 136), the main duties include management and communication, ie, getting feedback.

These numbers are due for an update because so many changes have occurred in the infection prevention and control profession since 2017. But it is believed the majority of IPs are still nurses.

IPs play multiple roles, including the following:

Source: Linda Spaulding, RN-BC, CIC, CHEC, CHOP

The ability to be an excellent IP requires lifelong learning and taking the initiative to grow professionally. IPs must have the ability to think quickly on their feet and adjust to an ever-changing environment of new resistant organisms, epidemics, pandemics, antibiotic shortages, and never-ending regulations from the Centers for Medicare & Medicaid Services (CMS), accreditation bodies such as DNV Healthcare or the Joint Commission, and the Occupational Safety and Health Administration (OSHA).

“Infection preventionists form the backbone of risk mitigation efforts around the country, but because their goal is to prevent something from happening, it’s harder to see what they do,” APIC’s 2020 president Connie Steed, MSN, RN, CIC, FAPIC, said in an APIC news release in September 2020. “COVID-19 has shown the world how crucial IPs are in keeping our communities safe.

The IP role involves not only patient safety, but also employee safety, and that includes educating hesitant health care workers about the safety and efficacy of the COVID-19 vaccines.

“COVID-19 has also shown most of the world the importance of vaccination,” says Blyth-Cheggour. “In my view, making COVID-19 vaccines mandatory (with minimal exceptions) is the only way to ensure patient and colleague safety. Health care workers need to trust the science showing these vaccines are effective in preventing the spread of COVID-19. Many vaccinations (hepatitis B, MMR, varicella, annual influenza) or proof of immunity are required for employment at many facilities so what is wrong with one more?”

IPs need to earn the trust and respect of all hospital stakeholders from the C-suite to the environmental service (EVS) workers and everyone in between, including the general public.

IPs also play a large role in education, from an IP’s the first day on the job with new hire orientation, to an IP’s last day on the job. IPs work in hospitals, ambulatory care centers, dental offices, surgical centers, urgent care centers, clinics, physician offices, home health care, nursing homes, assisted living facilities, restaurants, corporations, cruise ships, and even movie sets.

They must stay current on all the changes related to the area they are working or consulting in. Their schedule can range from 4 hours a day to 24/7. IPs do their job because they believe no one should acquire an infection regardless of where they are cared for.

Connie Henry, BSN, RNC, has been a nurse for 35 years, working in the areas of obstetrics, neonatal care, and infection prevention and control. “As an IP, I make rounds on my designated areas to act as a resource for clinical staff and to re-enforce hand hygiene,” she tells ICT®. “I attend the patient safety, quality, and reliability council meetings to be the IP liaison for the different projects. I am also a member of the [the quality assurance and patient improvement] community for rehab and home health.”

The COVID-19 pandemic has strengthened the ability of the IP to keep everyone—patients, visitors, staff, and vendors—safe as they enter health care facilities around the world.

What falls under an IP’s purview can include the following:

• use of personal protective equipment;
• gowns, gloves, eye protection;
• cleaning of equipment between patient use;
• hand hygiene;
• surveillance;
• monitoring central line infections;
• monitoring urinary catheter infections;
• monitoring for sepsis;
• monitoring for the presence of multidrug-resistant organisms-
• monitoring for proper antibiotic use;
• safe injection practices;
• policy changes to mitigate risk of infection;
• disease trends;
• pandemics;
• epidemics;
• community outbreaks;
• which patients need isolation and when they can be removed from isolation;
• stopping and preventing infections;
• monitoring processes in all departments from the C-suite to EVS;
• how vendor products are stored before delivery and how to reprocess them after delivery;
• reviewing loaner instruments or equipment;
• monitoring construction to prevent the spread of infectious diseases;
• how sterile supplies are processed and stored;
• what to do if sterile parameters are not met or if non-sterile instruments are used on a surgical case; and
• monitoring how outside laundry companies process health care laundry. Does the contractor laundry service use the correct water temperatures and appropriate detergent? Is linen stored and transported to the facility in the proper way to prevent contamination in transport?

This list can go on depending on the area of the IP’s expertise.

So as we approach Patient Safety Awareness Week, patients and health care workers might want to pause and thank an IP for the work he or she is doing. Let them know how important their jobs are and that society in general is aware of the mental and physical strain that COVID-19 pandemic has posed.

For IPs, it’s just part of the job description: keeping patients and health care professionals safe.

Linda Spaulding, RN, CIC, BC, CHEC, CHOP, is an infection prevention consultant and founder of InCo and Associates International, Inc.