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Why does an infection preventionist need to be certified? November 2, 2018

Why does an infection preventionist need to be certified? November 2, 2018. Craig H. Gilliam, BSMT, CIC, FAPIC Director Infection Prevention St Jude Children’s Research Hospital Craig.Gilliam@stjude.org. Why does an infection preventionist need to be certified.

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Why does an infection preventionist need to be certified? November 2, 2018

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  1. Why does an infection preventionist need to be certified?November 2, 2018 • Craig H. Gilliam, BSMT, CIC, FAPIC • Director Infection Prevention • St Jude Children’s Research Hospital • Craig.Gilliam@stjude.org

  2. Why does an infection preventionist need to be certified • No financial conflicts to disclose • Served on CBIC 2008 – 2014 • My opinions don’t expressly represent the policy of CBIC.

  3. Objectives: • What are the characteristics of successful IP applicant? • How is CIC a measure of IP’s proficiency? • Making the case for individual to certify

  4. Why a healthcare worker should certify? • The association between certification and improved outcomes in ICU, Med/Surg, Surgical areas and Oncology • Linked to improved ability manage symptoms, established guidelines knowledge, lower rates of adverse outcomes • Henman et al. AJIC 2015, Vol 43 pp 664-668

  5. Why does an infection preventionist need to be certified • Current responsibilities include: • performing surveillance specific to facility • Developing policies • Implementation and education of best practice • Monitoring compliance with bundles • Reporting to public and government • Oversight of preparedness

  6. Why does an infection preventionist need to be certified • Attaining CIC signifies that an IP is deemed competent to recognize, prevent, and control HAIs. • There is a relationship between successful IP programs and having a certified on staff. • Kalp et al. AJIC 2018 Vol 46 pp 858 - 864

  7. APIC MegaSurvey 4,078 respondents • 47% of individuals were certified • More likely to be certified: • Individuals between 56 – 65 were more likely to be certified • Individuals with greater experience in healthcare • Individuals with employer paid benefit for CIC • Kalp et al. AJIC 2018 Vol 46 pp 858 - 864

  8. APIC MegaSurvey 4,078 respondents • Respondents when CIC certified as expert: • Respondents when non-CIC self reported as proficient: • Identification of infectious disease processes • Preventing/Controlling the transmission of infectious agents • Surveillance and Epidemiologic Investigation • Environment of Care

  9. APIC MegaSurvey 4,078 respondents • Respondents when CIC certified or non-CIC self reported as proficient: • Employee and Occupational Health • Management and communication • Education and research • Cleaning, sterilization, disinfection and asepsis

  10. What is the supporting evidence? • Certified IP has impact on infection rates relative to MDRO. • 180 California hospitals surveyed • Certified IP Director had significantly lower MRSA bloodstream infections. • More valuable than # of IP per 100 beds • Pogorzelska et al. AJIC 2012, Vol 40 pp 96-101

  11. What is the supporting evidence? • Perception the evidence for supporting infection prevention implementation stronger than non-certified IP • 703 US hospitals surveyed • CAUTI, CLABSI, VAP, general IP practices • Saint et al. AJIC 2013, Vol 41 pp 100 - 106

  12. What is the supporting evidence? • A 2 fold increase in odds of reporting evidence for antimicrobial stewardship program • A 2 fold increase evidence for nurse initiated discontinue of urinary catheter • 40% decrease in understanding risk of routine CVC changes • Saint et al. AJIC 2013, Vol 41 pp 100 - 106

  13. What is the supporting evidence? • A survey of IP to assess 5 program areas related to immunization • 1000 responses from 2011 • Assessing performance, respondents who are CIC scored significantly higher in overall program performance • Carrico et al. AJIC 2013, Vol 41 pp 581-584

  14. Why does an infection preventionist need to be certified • Part of the job qualification for IP (or within 2 years of employment) competency • May be required for leadership position • TJC may ask about CIC as part of program competency • Points on national surveys – USN&WR

  15. Objectives for CBIC – 10,000 by 2020 • Approximately 65% of 1st time applicants are successful (2015 data) • In 2016 94% of recertification applicants were successful

  16. CIC Preparation • Identification of infectious disease processes (22 items) • Preventing/Controlling the transmission of infectious agents (25 items) • Surveillance and Epidemiologic Investigation (24 items) • Employee/Occupational Health (11 items) • Management and communication (13 items) • Cleaning, Sterilization, disinfection, Asepsis (15 items) • Education and Research (11 items) • Environment of Care (14 items)

  17. CIC Preparation tools to prepare • Each item (question) on the examination will target different cognitive levels. • These levels are: • Recall – a gram stain result is positive – the color of microorganism is purple or pink or red? • Application – a patient with pertussis is placed on what type of precautions – Droplet or airborne or contact? • Analysis – a bacterium that can grow in absence of oxygen but is also able to use oxygen for growth is a facultative anaerobe. An example would be Staphylococcus or Fusobacterium or Influenzae?

  18. CIC Preparation tools to prepare • Each item (question) on the examination will target different cognitive levels. • These levels are: • Recall – a gram stain result is positive – the color of microorganism is purple or pink or red? • Application – a patient with pertussis is placed on what type of precautions – Droplet or airborne or contact? • Analysis – a bacterium that can grow in absence of oxygen but is also able to use oxygen for growth is a facultative anaerobe. An example would be Staphylococcus or Fusobacterium or Influenzae

  19. CIC Preparation tools to prepare • The CIC exam consist of 150 multiple choice questions with 135 scored. Fifteen are in pretest for evaluation. • CBIC recommends reviewing the Examination Content Outline in conjunction with the primary and secondary references • APIC sells an exam review guide that they create and publish. The Certification Study Guide, 6th edition

  20. Why does an infection preventionist need to be certified • References, Primary • APIC Text of Infection Control and Epidemiology • Kulich P, Taylor D, eds. The Infection Preventionist’s Guide to the Lab • Heymann, D., ed. Control of Communicable Diseases Manual • Brooks, Kathy. Ready Reference for Microbes References, Secondary • Current Recommendations of the Advisory Committee on Immunization Practices (ACIP). • Current guidelines, standards, and recommendations from CDC, APIC, SHEA, and Public Health Agency of Canada. • Pickering, Larry K, ed. Red Book,

  21. Why does an infection preventionist need to be certified

  22. Why does an infection preventionist need to be certified • Measure of competency of the individual professional in complex healthcare settings • An increase in medical literature that certification is necessary to achieve better outcomes and understand current practice recommendations • It is a personal thing to show I am objectively the best!

  23. Questions?

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