infection prevention and control workshopand/or infection control? is the nursing home financially...
TRANSCRIPT
Why did you become an Infection Preventionist (IP)?
What training have you obtained for IP?
What areas of IP do you need most assistance with?
The Why
How many infections have you had in the last year:
What infections are most common in your facility:
Where do you think your facilities biggest lapses are:
Infections in Long-term Care (LTC)
Infection Program Meet Regulations?
Yes:
No:
If No, Why:
What are your roles as the IP?
What other departments are involved in infection prevention and control?
What areas are your priority to improve in your program?
1.
2.
3.
Roles
What are you utilizing for surveillance?
Is the data being used to drive action, if so how?
Has your facility experienced any outbreaks? If so, what?
Surveillance
Process Measures Outcome Measures
Review of practices by staff directly related to resident care
Identify whether staff implement and comply with the facilities IPCP policies and procedures
Addresses the criteria that staff would use to identify and report evidence of a suspected or confirmed HAI or communicable disease
Collecting/documenting data on individual resident cases and comparing the collected data to standard written definitions (criteria) of infections
Current Process Measures Current Outcome Measures
Future Process Measures Future Outcome Measures
Reporting
The infection site(i.e., type of infections)
Pathogen (if available), Signs and symptoms Resident location Summary and analysis of number
of residents (and staff, if applicable) who developed infections
Observations of staff including the identification of ineffective practices (e.g., not practices hand hygiene and/or using PPE
Practices that do not follow the IPCP policies and procedures (if applicable)
The identification of unusual or unexpected outcomes(foodborne outbreak), infection trends and patterns
Staff Medical Director Director of Nursing Quality Assessment Assurance Committee-QAA
WHO WHAT
WHERE
Agencies to Report to
Local Health Department County/Number:
State Health Department: State/Number:
Enroll into NHSN: https://www.cdc.gov/nhsn/ltc/enroll.html
Antibiotic Stewardship
1. Gather A Team
Who can serve on the antimicrobial stewardship team?
2. Assign Roles and Responsibilities
What are the roles and responsibilities?
Name Title Roles, Responsibilities, and Task
Phone and Email
3. Readiness Assessment
Is the Nursing Home Ready? Yes No
Is key leadership supportive of this effort?
Is the medical director actively involved in quality improvement and/or infection control?
Is the nursing home financially stable?
Is the nursing home’s ownership and/or management stable?
Is the nursing home in good standing with the State Survey Agency?
Are there at least two staff who can serve as program champions and commit to leading the activity?
Is there time to train staff?
Are there resources for implementing mechanisms to sustain the effort?
4. Implementation Planning and Sample Agenda
Develop a timeline, responsibilities, a budget, and a schedule for team meetings
Consider the facilities unique characteristics, needs, and resources, and think about specific items—such as costs for supplies and staff time—that will be needed to carry out the antimicrobial stewardship program
Utilize an agenda, policies, and procedures
5. Draft Policies and Procedures
Draft Policies and Procedures for the Antimicrobial Stewardship Program
A statement of the nursing home’s commitment to quality care
A statement of the purpose and scope of the program, including what the antimicrobial stewardship program plans to accomplish
A description of the program and its goals
The date of the new program will begin
A list of who will participate in the program
5. Draft Policies and Procedures
Hand Hygiene
Where do you have hand sanitizers located?
What hand sanitizer does your staff prefer?
What is your HH compliance?
What do you think your biggest obstacle is for improving HH compliance?
Personal Protective Equipment
What are your PPE compliance rates?
What do you think your biggest obstacle is for improving PPE compliance?
What is the Proper order for Donning?1.2.3.4.
What is the Proper order for Doffing? (2 ways accepted)1.2.3.4.5.
Transmission-Based Precautions
What transmission-based precaution do you use?
C. Difficle:
MRSA:
Influenza:
Measles:
Other:
Safe Injection Practices
https://www.cdc.gov/vaccines/adults/rec-vac/hcw.html
Describe the areas that can improve to make injection safety more effective.
1.
2.
3.
Respiratory/Cough Etiquette
https://www.cdc.gov/vaccines/adults/rec-vac/hcw.html
Describe what your LTC does to enhance respiratory/cough etiquette.
1.
2.
3.
4.
Infusion Therapy (Central Venous Catheters)
Point-of-Care
Describe infection control practices for point-of-care.
1. Aseptic Technique:
2. Cleaning and Disinfecting:
3. CDC recommendations:
Urinary Catheter Appropriate vs InappropriateAction Appropriate or Inappropriate
Critically ill with need for intake and output monitoring
End-of-life comfort
Convenience
Prolonged immobilization
Specimen collection for residents who can void
Acute urinary retention or bladder outlet obstruction
Respiratory Therapy
Skin
What does your assessment for potential infection include?
What are the steps you take to prevent skin breakdown?
What forms of respiratory therapy does your facility offer?
Sterile vs CleanSterile Clean
Intervention Handwashing Technique
Wound cleansing
Routine dressing change without debridement
Dressing change with mechanical, chemical, or enzymatic debridement
Dressing change with sharp, conservative bedside debridement
Healthcare Personnel/Occupational Health
State Regulations for Employee TB Testing and Screening
State:
Regulation:
TB Screening Influenza Vaccinations
State Regulations for Employee Influenza Vaccination
State:
Regulation:
https://www.cdc.gov/vaccines/adults/rec-vac/hcw.html
What information need to be recorded for resident’s and staff vaccination?1.2.3.4.5.
Where do you store your vaccines?
What are some strategies your facilities have in place to encourage influenza vaccinations?
Vaccinations
Exposure Control Plan
Do you have an Exposure control plan?
If so, what areas does it address?
Should an exposure incident occur: Who do you contact: What is their number:
What is your biggest concern for an incident occurring?
How can you improve your programs efforts to prevent this?
Cleaning and Disinfection of Environmental surfaces and Reusable EquipmentWhat are some reusable equipment/ medical devices used in your facility and how are they clean/disinfected?
What order should rooms be cleaned?
What order should restrooms be cleaned?
What cleaning products does your EVS staff use? Are they EPA Approved?
Where do you store your cleaning equipment?
Linen
What is your method for transporting linen?
Where is your linen stored? Is it stored appropriately?
Describe how laundry are cleaned. For example appropriate water temperature.
Water Management
Describe why water management is important.
List the steps to having a water management program.
Food Service• Describe the top 5 breaches in infection control practices
• Describe five opportunities to reduce the risk of foodborne illnesses
Direct Observation/Education and Competency
List the direct observations that you are currently performing AND documenting
Action Plan
What can I do Today?
What can I do this week?
What can I do this month?