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Infection Control Risk Assessment. Terrie B. Lee, RN, MS, MPH, CIC Director, Infection Prevention & Employee Health Charleston Area Medical Center Charleston, WV. Organizational Infection Risk Assessment. Part of infection prevention and control planning process

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infection control risk assessment

Infection Control Risk Assessment

Terrie B. Lee, RN, MS, MPH, CIC

Director, Infection Prevention & Employee Health

Charleston Area Medical Center

Charleston, WV

organizational infection risk assessment
Organizational Infection Risk Assessment
  • Part of infection prevention and control planning process
  • Serves as starting point of well-developed plan
  • Together with plan, form foundation of program
  • Assists in focusing surveillance and other program activities
  • Meets regulatory requirements
infection risk assessment regulatory influence
Infection Risk AssessmentRegulatory Influence
  • Identify risks for acquiring and transmitting infections based on:
    • Geographic location, community, and population served
    • Care, treatment, and services provided
    • Analysis of surveillance activities and other infection data
  • Risks identified annually and when significant changes occur
infection risk assessment regulatory influence1
Infection Risk AssessmentRegulatory Influence
  • Risk assessment occurs with interdisciplinary input:
    • Infection prevention personnel
    • Medical staff
    • Nursing
    • Leadership
    • Others
  • Prioritize and document risks
risk assessment process
Risk Assessment Process
  • Homework and Planning
    • Forms
      • Preliminary completion of organization evaluation form
      • Preparation of risk assessment form
    • Standards
    • Reports: Surveillance data
    • Knowledge of current issues
risk assessment process1
Risk Assessment Process
  • Team Recruitment
    • Invitation
    • Solicit information in advance
      • What are the most important infection prevention and control problems?
      • What are our most frequent reasons for visit, admission, procedures performed, etc.?
risk assessment team
Risk Assessment Team
  • IP Staff
  • Employee Health
  • Medical Staff
  • Laboratory
  • Pharmacy
  • Nursing
  • Surgery
  • Ambulatory Services
  • Environmental Services
  • Engineering
  • Administration
  • Central Processing
  • Quality/Performance Improvement
  • JC Coordinator
risk assessment meeting
Risk Assessment Meeting
  • Commitment for attendance/ participation
  • Time for thoughtful discussion
  • Prioritizing risks
  • Determining IP Plan
organization evaluation
Organization Evaluation
  • Factors to Include:
    • Geographic and environmental
    • Population characteristics
    • Area endemic infections
    • Other area-related risks
    • Medical care characteristics
    • Services provided
organization evaluation1
Organization Evaluation
  • Description of factors
  • Characteristics that increase risk for infection
  • Characteristics that decrease risk for infection
  • Get input at meeting for final completion of form
  • Include findings in risk assessment
risk assessment
Risk Assessment
  • The group work begins!
risk groups
Risk Groups
  • Antibiotic-resistant organisms
  • Failure of prevention activities
  • Isolation activities
  • Policy & procedure
  • Preparedness
  • HAIs
  • Environment
  • Employee Health
  • Other
assigning three values to each risk
Assigning Three Values to Each Risk
  • Probability of event occurring
  • Impact/severity
  • Current systems
probability considerations
Probability Considerations
  • Known risks
  • Historical data
  • Reports in literature
impact considerations
Impact Considerations
  • Threat to life and/or health
  • Disruption of services
  • Loss of function
  • Loss of community trust
  • Financial impact
  • Legal issues
  • Regulatory impact
  • Standards/requirements
current systems considerations
Current Systems Considerations
  • Current policy & procedure
  • Implementation of plans
  • Training status
  • Measures of outcome or process
  • Availability of backup systems
  • Community/public health resources
how to assign values
How to Assign Values
  • There are no right or wrong answers!
  • Allow discussion
  • Push group for consensus
  • Keep group focused, on target
  • Important to be consistent
  • Go through entire list of risks
  • Assign someone to calculate risk scores
risk score
Risk Score
  • Derived from multiplication of three component numbers
  • Group consensus vs. mathematical averaging or summation
prioritization
Prioritization
  • Rank order risks using risk scores
  • Each organization’s priorities will be different
risk assessment exercise
Risk Assessment Exercise
  • Determine fictitious setting
  • Discuss each potential risk
  • Come to group consensus on assignment of number for each component
  • Multiply component numbers to calculate risk score
  • Occasionally compare risk scores to validate with group
infection prevention plan regulatory influence
Infection Prevention PlanRegulatory Influence
  • Written infection prevention plan
    • Goals
    • Measureable objectives
    • Strategies for implementation
infection prevention plan regulatory influence1
Infection Prevention PlanRegulatory Influence
  • Goals based on prioritized risks and include:
    • Limiting unprotected exposure to pathogens (isolation precautions and use of PPE)
    • Limiting transmission related to procedures
    • Limiting transmission related to medical equipment , devices, supplies
    • Improving hand hygiene
infection prevention progress report
Infection Prevention Progress Report
  • Priority
  • Goal
  • Objectives
  • Strategies
  • Evaluation method
  • Current status/ Evaluation/ Next Steps
sample goal objectives
Sample Goal & Objectives

Assessment: Personnel wash hands or use alcohol hand rub during direct patient care activities.

Goal: Increase use of hand hygiene

Objective: Increase use of hand hygiene by direct care providers on 3 North by 40% in the next 6 months

infection prevention progress report exercise
Infection Prevention Progress Report Exercise
  • For top three scored risks, complete the following:
    • Goal
    • At least one objective
    • Strategies to reach objective
    • Method of evaluation
benefits of risk assessment meeting
Benefits of Risk Assessment Meeting
  • Spreading the knowledge of what you “do”
  • Getting buy-in and support from key organizational stakeholders
  • No individuals to blame for priorities – organizational decisions
  • Many people able to articulate how IP plan was created
  • Meets regulatory requirements
infection prevention progress report2
Infection Prevention Progress Report
  • Tracks most important aspects of IP program
  • Reporting mechanism
  • Demonstrates program results/ improvement
summary
Summary
  • Each organization must conduct an infection risk assessment that is unique to itself. This risk assessment is used to set priorities for the infection prevention program.
  • Once priorities are identified, goals, objectives, and strategies help to create the organizational infection prevention plan.
summary cont
Summary, cont.
  • The risk assessment process is ongoing, with a focused revision taking place annually.
  • A progress report can be used to track and report priorities and accomplishments of the infection prevention program.