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Infection Preventionist: Your Role in the Acute Care Setting

Infection Preventionist: Your Role in the Acute Care Setting. Linda R. Greene, RN, MPS,CIC,FAPIC Manager, Infection Prevention UR Highland Hospital Rochester, NY l inda_greene@urmc.rochester.edu. Objectives. Describe the role of the Infection Preventionist in the Acute Care setting

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Infection Preventionist: Your Role in the Acute Care Setting

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  1. Infection Preventionist: Your Role in the Acute Care Setting Linda R. Greene, RN, MPS,CIC,FAPIC Manager, Infection Prevention UR Highland Hospital Rochester, NY linda_greene@urmc.rochester.edu

  2. Objectives • Describe the role of the Infection Preventionist in the Acute Care setting • Discuss changes in the role over the past 10 years • Identify key skills needed for a successful program

  3. Primary Role Prevention

  4. Historical Role • Data collector • Reviewed CDC guidelines • Education of staff – focused mainly on nursing • Reported findings to committee

  5. What Happened? • Thousands of patients developed HAIs • Many device associated infections • Difference between policy and practice

  6. Changing Landscape

  7. Change Happened • Consumer demands • Press • Resistant organisms and super bugs • Outbreaks with devices and products • Public reporting

  8. Media Have Expanded and Rapid Involvement -

  9. Continuing Emerging Threats • Bioterrorism • Natural disasters • Re-emergence of old diseases or those not prevalent in the U.S. (Measles, Ebola, Pandemic Influenza) • Antibiotic resistance • Candida auris

  10. Our Current Perspective HAIs harm patients A large majority can be prevented Consumers are aware of the HAI impact Demand for accountability Infection prevention is mandatory No one of us can do it alone, it takes a Village!

  11. IP Competencies Goals: • Connect with science and evidence based practice • Support ongoing role development • Emphasize the importance of certification • Remain relevant across IP’s career span • Apply across all practice settings

  12. How About Culture? .

  13. Implementation Science • Change in healthcare is needed • We must blend technical information with those social and adaptive skills necessary to bring evidence to the bedside • We will see expansion of these models: CUSP 4 Es Teamwork and Leadership training

  14. Change

  15. Don’t be this…

  16. How Do We Create What We Want the Future to Be?

  17. Culture of Safety What is culture? (climate) “The way we do things around here.” One person’s attitude = opinion Everyone’s attitude = culture

  18. High Reliability Organization (HRO) • Definition of HRO: Health care organization that functions in a hazardous environment, yet is essentially error-free for long periods of time (Roberts 1990) • Characteristics: organizational commitment to safety high level of backup steps to safety measures strong culture for continuous learning Weick ’02 Key concept: Interdependent teams vs. autonomous individuals

  19. Teamwork Disconnect M.D.- “Good teamwork means the nurse does what I say.” R.N.- “Good teamwork means I’m asked for my input.”

  20. Communication • Complete • Clear • Brief • Timely

  21. Tipping Point That magic moment when an idea, trend, or social behavior crosses a threshold, tips, then spreads like wildfire. 3 types of people: Connectors: know tons of people and gladly connect with them Mavens: seek out knowledge and share it with others Salesmen: instinctively garner support

  22. Highlights top level commitment • Physician-nurse alignment • Systematic education • Meaningful use of data • Rewards and recognition

  23. Physician and RN Collaboration % of respondents reporting above adequate teamwork

  24. Elevation of the Profession Clear Vision and Mission Vision: Healthcare without infection Mission: Create a safer world through prevention of infection Strategic Plan 2020 (pt. safety, implementation science, pt. advocacy, data standardization)

  25. Certification is Key Evidence supports certification: • Pogorzelska, Stone, Larson; “Certification in Infection Control Matters” AJIC; 2012 March • Krein; “Preventing ventilator associated pneumonia in the US”;ICHE 2008 • Saint; “Preventing hospital acquired urinary tract infection in the US”; Clin Infect Dis; 2008 GOAL: 50% of eligible APIC members

  26. Future of Certification • Link with institutional job descriptions • Use designation to strengthen role development and professional practice • Levels of practice: novice/advanced/expert

  27. Future Changes Future societal changes may include: • Antiaging drugs • Increased prevalence of chronic diseases • Universal medical records carried by every patient • Innovative methods for drug administration • Increased xenotransplantation • Geographic info systems to track pt. and HCW movement

  28. Old Skills Won’t Lead to New Outcomes “What Got You Here Won’t Get You There” by Marshall Goldsmith Leadership and Followership skills must be honed Leadership: ability to influence others-essential competency Transactional vs. Transformational Leadership Transactional - specifies roles and tasks; “one size fits all” Transformational - inspires followers to see beyond their self interest Saint/Krein “The only thing constant is change.” Heraclitus

  29. New Frontier of Leadership“Know Thyself” • Influence • Self knowledge • Strategic relationships • Reciprocity Manning;ICHE;2010

  30. Followership Kelly identified 5 key types of followers: • Alienated (mavericks, cynical) • Conformists (“yes” people) • Passivists (lack initiative) • Exemplary (innovative/independent, willing to question leaders)

  31. Human Barriers to Improvement 3 types of staff who present barriers: • Active resisters (if it ain’t broke, don’t fix it) • Organizational constipators (usually mid to high level execs, disinterested resistors) • Timeservers (serving out their time doing the least possible) One ingredient for success is anticipating common barriers!

  32. Skills Needed “The future is not something we enter. The future is something we create.” (Sweet) Emerging Knowledge Fields • Organizational dynamics • Data mining • Bioengineering • Social marketing • Health care economics • Green technology • Biomedical ethics

  33. Types of Leaders Leadership Behaviors • Designated • Situational Leadership Behaviors • Expert - based on specialized knowledge of task at hand • Facilitative – any member who can manage the process of the team’s work

  34. Leadership Repertoire Adapted from: Primal Leadership: Goleman, Boyatzis & McKee

  35. Effective Leaders • Set clear expectations • Identify priorities • Define who’s accountable • Effectively use all available resources

  36. Questions and Group Work

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