Onboarding Infection Preventionists? Some Questions to Ask

Infection control education for health care employees is a foundational requirement for all patient safety and health care–acquired infection (HAI) prevention and control programs. Retaining highly skilled and qualified infection preventionists (IPs) is essential to ensure patient safety. Regarding the extreme consequences of the COVID-19 pandemic, what measures can organizations execute to preserve individual safety while recruiting potential employees and orienting them? Because the size of each facility varies, the number of IPs can range from 1 or 2 to a much larger number, potentially requiring a department.

When a facility has to hire an IP, their preference is for an experienced candidate. However, the selection of candidates may only range from novices to those with limited experience. What is the best procedure for onboarding either a novice or an expert during these challenging times? If there are no experienced mentors or preceptors, what are some effective approaches a facility can implement? Will your facility have the option to hire a candidate who has acquired a certification, or provide a national certification within 1 year of hiring them?

Job Qualifications

Successful onboarding of candidates requires preparing an orientation that includes all aspects of the position. What are the responsibilities of an IP? Their main function is to identify and mitigate infection risks, although they have multiple responsibilities within a health care organization. These responsibilities typically include the following: reviewing the infection control plan within the facility, conducting surveillance to track infection trends, and developing and employing appropriate interventions to mitigate threats. Reporting communicable diseases to accrediting and governmental bodies and utilizing evidence-based infection prevention standards within the facility are also key functions. In addition, developing, implementing, monitoring, and revising infection control policies and procedures to assure compliance with the standards; preventing and reducing HAIs; and providing education to standards on the prevention of infectious diseases may also be among an IP’s responsibilities. As a result of the pandemic, additional responsibilities would include developing and implementing policies and procedures based on current standards of practice, and developing educational support systems that provide information on standards of practice, vaccination, and proper use of personal protective equipment (PPE).

Onboarding can be regarded as the systematic conversion of new employees into employees who exemplify the mission of the organization. By implementing a judiciously planned process, health care organizations can give new employees the information they need to fulfill their role and the tools to excel in their position. A positive onboarding experience also can be integral to their developing a strong allegiance to the facility.

An organized orientation that provides a comprehensive review of job descriptions, expectations, and policies and procedures and orients the employee to the job’s social aspects (eg, team building) is instrumental in retaining new hires. Expressing appreciation to them for joining the team and offering continual support are also essential for extending a warm welcome and sense of belonging, especially if the department is small. Providing a welcome bag with business cards for the new employee helps foster the sense of a long-term relationship and establishes a positive connection.

A review of the history, mission, and vision of the facility or organization at the beginning of the orientation process is helpful for the new employee to better understand the overall operational goals. Employees should review their job-related responsibilities and expectations verbally and in written form. Providing goals and checklists of orientation content and job skills can be valuable for the new hire and should be available during orientation. Also important is interacting with them throughout orientation to offer support and obtain feedback.

Have you ever considered having all new employees begin their orientation on a Friday instead of a Monday? They can meet current employees and team building can begin, allowing them to reflect on a great place to work over the weekend.

Questions, Questions

To embrace new learning principles, have you developed an orientation that enables new hires to learn at their own pace? Have there been updates to content areas that include the current infection control plan, risk assessment, pandemic and emergency plans, appropriate process and outcome measures, and accepted regulatory metrics? Does the pandemic plan orientation align with current Centers for Disease Control and Prevention and state and county guidelines for infectious diseases such as COVID-19? It is critical that employee orientation material be accurate and based on current evidenced-based practice. If your organization has several IPs, have you identified the priority areas the employee is to work in? These may include pandemic-associated issues, appropriate PPE use adherence, fit testing, hand hygiene, HAIs, and multidrug-resistant organisms. Does your orientation encompass strategies to mitigate infections throughout the facility?

Have you developed and reviewed your overall orientation plan for your new employee? Will the new hire have a preceptor? If this individual is solely responsible for infection control, will orientation include online learning, precepted experiences or videos, and a review of written materials? Will workshops or in-classroom instruction be available? Will simulation be available under the supervision of an experienced preceptor? Can your organization provide current educational tools and checklists? Will evidenced-based practice tools and competencies be available for the IP?

How do you orient the new employee if your organization is small and there are no other employees in the department to facilitate the mentoring or precepting process? You may consider hiring someone to facilitate the orientation process. National organizations or onboarding companies offer initial orientation and ongoing professional development education. If you can use a variety of learning methodologies, such as face-to-face, online, and hybrid learning, your orientation will most likely meet the learning style of the new employee.

Advantages of using a national organization include the new hire being introduced to nationally accepted metrics, evidence-based standards, and tools. One disadvantage is that the orientation will be online, which the employee may perceive as impersonal. The result of online orientation may be that the new hire does not form a connection with anyone in the organization.

For a virtual orientation, the employee’s work tools and virtual platforms should be accessible and operational. As a result of the COVID-19 pandemic, onboarding new employees has been challenging because of social distancing requirements. However, virtual onboarding can be implemented effectively by establishing measurable goals with competency-based checkpoints. The goals should be specific, measurable, realistic, relevant, and time specific. An effective learning process would be to present the content in smaller sequential modules. Incorporating checkpoints would help to ensure that the employee has assimilated the content before they proceed to the next module. It is essential that the new employee fully understands the expectations before proceeding with the learning process. Establishing weekly meetings with the employee will generate a mutual understanding of goal accomplishment.

These meetings are also a means to facilitate the assessment of the employee’s performance and address any potential areas of concern in a timely manner. Even small facilities can collaborate with other health care facilities to provide support from experienced individuals.

During the pandemic, orientation should include strategies to improve the psychological resilience of health care workers. Frequent meetings help maintain emotional health, and a healthy mental attitude can increase job satisfaction and employee retention. Further, including well-being content in your orientation will contribute to the quality of patient care.

Certification

Can you provide membership for your new hire in the professional organization? After the successful orientation of your new employee, you may want to consider having them sit for the certification examination. This credential shows mastery in knowledge of infection prevention and control. Assisting in their attaining certification shows the employee you are committed to their success and professional development. Encouraging certification shows a commitment on the part of the health care facility to best practices in infection prevention and control. Supporting the education process and acknowledging a level of expertise through certification advances patient care and safety within the organization.

New employees are seeking positions that provide orientation, support, and educational resources to develop the knowledge and skill set they need to meet the demands of the job and life-changing events. By establishing a comprehensive and well-structured orientation process, the facility is investing in generating competent employees who demonstrate their allegiance to the mission and goals of the institution and, most importantly, to the safety and welfare of all the patients and staff members.

MARY JEAN RICCI, MSN, RNBC, is the director of clinical education and an assistant clinical professor at the College of Nursing and Health Professions at Drexel University in Philadelphia, Pennsylvania.

JOYCE WELLIVER, MSN, CRNP, is an assistant clinical professor at the College of Nursing and Health Professions at Drexel University in Philadelphia, Pennsylvania.

Resources:

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Mollohan J, Morales M. Strategies for successful perioperative orientation. AORN J. 2016;104(2):100-110. doi:10.1016/j.aorn.2016.06.002

Shinners J, Africa L, Hawkes B. Debriefing as a supportive component for registered nurses in transition. J Nurses Prof Dev. 2016;32(4):212-8. doi:10.1097/NND.0000000000000273