infection control assessment
TRANSCRIPT
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Infection Control Assessment
and Response (ICAR) Tools
Fresh Eyes
Collaborative Approach
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Infection Control Assessment and
Response (ICAR) Tools
Comprehensive documents/questionnaires identify elements of infection prevention programs
• Hospitals
– acute/short-term
– critical access (CAH)
– long-term (LTACH)
• Long-term care (LTC)
• Outpatient [including ambulatory surgical centers (ASC)]
• Hemodialysis [end stage renal disease (ESRD)]
Source: CDC Infection Control Assessment Tools
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Centers for Disease Control and
Prevention (CDC) ICAR Program
Goals
• Assist health departments and facilities
• Assess infection prevention practices
• Identify gaps
• Guide quality improvement activities
Source: CDC Infection Control Assessment Tools
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United States ICAR Visits
• Over 1500 facilities have participated
• Each State has a different approach
• All collaborative and non-regulatory
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Collaboration
Thank you!!!!
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ICAR Program in Illinois• CDC funded program
– Illinois Department of Public Health
– Chicago Department of Public Health
• Identify gaps
• Provide education and training
• Detect, respond to, and prevent healthcare
associated infections and multidrug-
resistant organisms
Source: IDPH, CDPH, Lavin, MA Prevention Strategist
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APIC Consulting and the ICAR
Program
• Full time and part time nurse consultants
• Specialties in acute care, ambulatory care,
dialysis, Ebola, and long-term care
• All certified in infection control (CIC ®)
• Advisor and data managers
• Subject matter experts
• APIC Consulting Staff
Source: IDPH, CDPH, APIC Consulting, Lavin, MA Prevention Strategist
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APIC Consulting and the ICAR
Program
• APIC Consulting Team provides
– ICAR assessments and feedback
– Ebola preparedness support
– Outbreak support
– Education and training
Source: IDPH, CDPH, APIC Consulting, Lavin, MA Prevention Strategist
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APIC Consulting and Additional
Assessment Tools
• Supplemental Tools
– Disinfection/Sterilization
– Ventilator care
– Wound care
• Allow for more in-depth collection of
information
Source: IDPH, CDPH, APIC Consulting, Lavin, MA Prevention Strategist
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Illinois ICAR Process Summary
• Overall goal is safety of patients, residents and healthcare providers
• Voluntary and collaborative
• Interdisciplinary team (IDT), APIC Consulting and public health participants
• Pre-assessment
• Onsite visit with “fresh eyes” with over 200 years of collective experience!
• Report of findings to facilities
– Verbal and written
Source: IDPH, CDPH, APIC Consulting, Lavin, MA Prevention Strategist
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Healthcare Personnel (HCP) Infection
Prevention (IP) Competency and Basic
Training
• The proven ability to apply essential
knowledge, skills and abilities to prevent the
transmission of pathogens during the
provision of care
• The provision of job-specific education,
training and assessment to ensure that
healthcare personnel possess IP competency
Source: CDC Infection Control Assessment Tools
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Competency Assessment
• Knowledge-based testing
and direct observation
• Direct observation or
alternative method
• Ensure HCP possess
– Essential knowledge
– Skills
– Abilities
Source: CDC Infection Control Assessment Tools
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Audit• Direct
observation or
monitoring of
healthcare
personnel
adherence to
job-specific IP
measures
Source: CDC Infection Control Assessment Tools
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Feedback
• Feedback: A
summary of audit
findings that is
used to target
performance
improvement
Source: CDC Infection Control Assessment Tools
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CDC Infection Control Assessment and
Response (ICAR) Common Domains
• Infection Control Program and Infrastructure
• Hand Hygiene
• Personal Protective Equipment (PPE)
• Injection Safety
• Environmental Cleaning
Slide: D Burdsall 16
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ICAR Acute Care
Site Specific Domains• Central Line Associated Blood Stream Infection
(CLABSI) Prevention
• Catheter Associated Urinary Tract Infection (CAUTI) Prevention
• Ventilator Associated Event (VAE) Prevention
• Surgical Site Infection (SSI) Prevention
• Clostridium difficile infection (CDI) Prevention
• Healthcare Associated Infection/Multi Drug-Resistant Organism (HAI/MDRO) Systems Prevention
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ICAR Long Term Care
Site Specific Domains
• Healthcare Personnel and/or Resident Safety
• Respiratory/Cough Etiquette
• Surveillance and Disease Reporting
• Antibiotic Stewardship
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ICAR Outpatient
Site Specific Domains
• Healthcare Personnel and/or Resident Safety
• Respiratory/Cough Etiquette
• Surveillance and Disease Reporting
• Sterilization and High Level Disinfection
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ICAR Hemodialysis
Site Specific Domains
• Healthcare Personnel and/or Resident Safety
• Respiratory/Cough Etiquette
• Surveillance and Disease Reporting
• Dialyzer Reprocessing Use
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Illinois ICAR
Preliminary Trends and Patterns
• Convenience sample from the over 125 facilities that have been visited by APIC Consultants
• No facility identifiers
• Both quantitative and qualitative data is being collected
• Facilities receive recommendations at verbal exit and written report
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17 Acute Care Facilities ICAR Gap Analyses
17 17 16 16 1615 15
1413 13
11
0
2
4
6
8
10
12
14
16
18
Gap
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31 Long Term Care Facilities ICAR Gap
Analyses
31 29 29 28 2825 24 24
20
0
5
10
15
20
25
30
35
Gaps
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9 Outpatient ICAR Gap Analyses
9 9 98 8
65
32 2 2 2
00
1
2
3
4
5
6
7
8
9
10
Gap
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3 Freestanding Hemodialysis ICAR GAP
Analyses
3 3 3 3 3
2
1 1
0 00
0.5
1
1.5
2
2.5
3
3.5
Gap
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Major Gaps • Infection Prevention and Control Program
• Hand hygiene perceptions and performance
• Environment
• PPE
• Competency and audits
• Reprocessing
• Policy and Procedure Review
• Antibiotic Stewardship
• Injection Safety
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Wordclouds.com
GAP
Themes
Environment
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Exercise• Define Personal Protective Equipment
• Demonstrate the donning and doffing of PPE
28Photo: Mommarazzi Images
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OSHA Definition of Personal
Protective Equipment (PPE)
• Does not permit blood or other potentially
infectious materials to pass through
• Protects employee clothes, skin, eyes,
mouth, or other mucous membranes
• Under normal conditions of use
• For the duration of time which the protective
equipment will be used
29Burdsall2017
Occupational Safety and Health Administration. Standard 29 CFR 1910.1030 Bloodborne Pathogens
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PPE from the CDC
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Next Steps
Working With Public Health
• Continue ICAR Visits
• Contact Ruth Belflower, APIC Consulting if
interested: [email protected]
• No cost to the facility
• Collaborative, not regulatory
• Follow-up support after ICAR
• Focus on observed gaps
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Thank you!
• APIC
• APIC Consulting Team
• Chicago Department of Public Health
• Illinois Department of Public Health
• Rush University Epicenter
Questions? [email protected]
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