Redefining Competency: A Comprehensive Framework for Infection Preventionists

APIC (Association for Professionals in Infection Control and Epidemiology)

(Image credit: APIC)

Ongoing competency evaluation, record-keeping, and professional development are essential throughout an infection preventionist’s (IP’s) career, as highlighted in a commentary published in the American Journal of Infection Control.

As infection prevention and control continue to take center stage in health care, ensuring the ongoing competency of infection preventionists (IPs) has become more critical than ever. Infection Control Today^® (ICT^®) sat down with Christine Zirges, DNP, ACNS-BC, CIC, FAPIC, system director of infection prevention at SSM Health and Chair of the Association for Professionals in Infection Control and Epidemiology’s Professional Development Committee.

Zirges was the lead author of “A Framework for Defining and Documenting Infection Preventionist Competency,” a commentary published in the American Journal of Infection Control. This comprehensive article outlines the importance of continual competency assessment, documentation, and career advancement for IPs at every stage of their professional journey.

In this interview, Zirges shares key strategies for assessing and articulating IP competency, addressing regulatory surveys, and promoting ongoing professional development. She emphasizes why competency goes beyond certification and how organizations can implement sustainable frameworks for IP growth, ensuring excellence in infection prevention and control.

ICT: Why was this commentary written?

Christine Zirges, DNP, ACNS-BC, CIC, FAPIC: In recent years, there has been a significant increase in the need for IPs not only in nonacute care settings but also in other areas, such as consultation, various practices in industry, and long-term care, for instance. Secondly, and rightly so, more emphasis is placed on quality and patient safety, along with regulatory requirements to protect patients from harm. These factors led us to examine the true competencies of an IP, how to manage and document them, and how to optimize to meet the demands of the increased scope and settings. This caused us to reconsider our current APIC competency definition, review the literature, look at other settings, and even update our competency definition. We also included some language about collaboration with interprofessional partners and working within teams because IPs can't perform this job alone. It is about interprofessional partnerships.

How do you do that if you are newer to the role? How do you have those conversations with leaders or teams who own various work processes in their departments? Perhaps with department leaders, it becomes “I'm here to help facilitate getting that done or making recommendations.” All team members can then include their expertise in infection control practices in all those different settings. There are procedural areas, nursing care areas, and outpatient or ambulatory settings, for example. There are all these different settings where infection prevention requirements and practices have to occur, but infection prevention doesn’t necessarily own it all. How do you leverage your skill set and the competency of your role in working with various partners to ensure safe care is provided?

ICT: Environmental services, sterile processing, and others, including regular nurses and doctors, must work together. What are the key elements of the competency assessment framework outlined in the APIC commentary, and how can IPs effectively integrate these into their career development plans?

CZ: To support this competency work is the APIC Infection Preventionist Advancement and Career Development Guide, released this year. That set the framework for outlining the growth of the IP role; we outlined the various competencies and skill sets needed for IPs in their professional growth.

Think of that guide as the foundation because it encompasses the skills and competencies of the role. We also included examples of job descriptions and self-assessment tools. Think of that package as a framework. It's the how. Here are the tools; here is how you can do this. The competency framework reviews approaches to assessment, management, and documentation.

That is what our white paper attempts to do. In other words, how and when do you utilize those tools to assess your competency? Do you complete it at onboarding? Do you complete it once a year? Are there organizational policies that support your regulatory requirements? Management of the competency program is discussed in terms of how you manage the IP competency program. Where are those files kept? Who keeps the files? Who can retrieve those files? Are there policies written for that? The management piece is the next part, and the third is interprofessional collaboration, which I discussed because it is ongoing in your role. How do you work with teams?

Lastly, we looked at literature across other industries; some organizations or conversations have turned interprofessional collaboration into competencies because it has been shown that the strength of organizational interprofessional competencies positively impact patient safety outcomes. We included that component, just briefly, but offered some tips on how to be successful in that space because sometimes it can be daunting if you're working in teams.

And to go back to your example, we don't necessarily own environmental or procedural area practices, but we are subject matter experts; we have the competencies to direct that, utilizing infection control standards or regulations. We have a seat at the table, but rather than take it on and own it, how do you have those conversations? How do you facilitate those recommendations on these teams? Sometimes, it's with leaders. Sometimes, you must be very clear about your role in that space.

ICT: You've mentioned that assessing and documenting the IPs' competency throughout their career is essential. What intervals or events should trigger a reevaluation?

CZ: Following organizational policies and regulatory guidelines is definitely important. Secondly, if there's a significant change in your job scope, responsibility, or job description, that is an opportunity to conduct a skills assessment and/or a competency assessment.Annual assessments are a perfect time to see where you're at and to develop goals for the following year.

Much of this is outlined in the guide I mentioned, [Infection Preventionist Career Development and Advancement Guide], detailing some recommendations and the tools to utilize. Competency is just one piece of it. Documenting not just the competency but education and experiences you're including in your career portfolio, along with keeping track of your desired career needs.

As our paper reflects, the updated competency definition involves the knowledge, skills, abilities, and behaviors required for effective job performance. But assessing it reveals opportunities for growth and creates your own career portfolio too, giving you some responsibility and control over your needs and how to achieve them. If you want to develop in a specific area or have needs identified in your competency assessment, like, "I could use some more knowledge, perhaps in working with teams," maybe a facilitation class, or whatever that gap might be. The competency assessment allows you to identify where your needs might be.

ICT: Every IP panics when regulatory or accreditation surveys unexpectedly arrive. How can IPs prepare to articulate and demonstrate their competence? What competency programs and documentation are most critical?

CZ: That is a great question because that is also what we outline in the paper: a framework. It's important to understand and be able to articulate your organizational policies. We include some conversation about that. Ask yourself: Does my organization have a policy on annual requirements for demonstrating and documenting competencies? Are they specific to the requirements of my role and job description? Does the academic and certification language within your specific job description align with what those in the role have?

Having the ability for you and your leader to access the completed documents is very important and should also align with the organization’s policy.Are the completed documents accessible within a learning management system?If needed during a regulatory survey, who has access to produce any documents related to competency documentation?

ICT: How do infection preventionists use “the Guide” to demonstrate competency?

CZ: The guidepost for the infection preventionist role is the APIC competency model. Infection Preventionist Career Development and Advancement Guide, already referenced, highlights that model and includes tools and examples for integrating it into practice. It is a one-stop-shop useful when presenting your approach to competency documentation and management.

That is a critical piece, and to be able to explain it and how you approach IP competency while leaning on the APIC tools and competency model to have that conversation. Nobody knows the IP’s role like I do.

Lastly, it is important to understand that certification is not the be-all and end-all of competency. It is merely one element of competency.

ICT: Many nurses who perform IPC duties often aren't CIC or have any certification in IPC simply because they've never had to; if they're a director of nursing of a long-term care facility, then they're not necessarily going to be certified.

CZ: There are many benefits to certification, and unique situations or practice locations may require it. APIC offers several certifications appropriate for various career stages and practice locations. There is still a requirement to demonstrate competency in your role, and that's equally important. Usually, this is an annual requirement. But again, I go back to following your organizational policies.