zero tolerance: the icp, tsicp, and apic sue sebazco, rn, bs, cic infection prevention/employee...
TRANSCRIPT
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Zero Tolerance:The ICP, TSICP,
and APIC
Sue Sebazco, RN, BS, CIC
Infection Prevention/Employee Health Director
Arlington, TX
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Objectives
1. Recognize the value TSICP and APIC provide for the individual ICP.
2. Discuss the strategic role members of TSICP and APIC contribute to infection prevention and control systems that promote zero tolerance and safe patient care.
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Zero Tolerance
What is aiming for “zero”?
Where did it come from?
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Infection Control in 1972
Profession the result of Staphylococcus aureus pandemic of the 1950’s
The first ICPs
Early Infection Control Programs
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The ICP in 1980Knowledge and Abilities
Understand nursing procedures Isolation techniqueAseptic techniqueUse of pt care equipmentAdequate decontamination, disinfection,
sterilization Hospital Infection Control Principles and Practices, Mary Castle 1980
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The ICP in 1980
Knowledge and AbilitiesMicrobiology Infectious diseasesEpidemiologyAdministration and SupervisionEnvironmental sciences
Hospital Infection Control Principles and Practices, Mary Castle 1980
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APIC FUTURES SUMMIT – 2004APIC FUTURES SUMMIT – 2004 What Happened?What Happened?
More than 50 experts from across the continuum of healthcare,
APIC leaders, and
industry partners convened.
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APIC FUTURES SUMMIT – 2004APIC FUTURES SUMMIT – 2004 The Future of HealthcareThe Future of Healthcare
“Every 30 or 40 years, something comes along that completely redefines everything about healthcare.”
– Jeffrey Bauer: Healthcare Futurist
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APIC FUTURES SUMMIT – 2004APIC FUTURES SUMMIT – 2004Top Healthcare TrendsTop Healthcare Trends
Molecular medicine
Digital information technology
Diversity of society
Globalization of commerce
Emergence of new diseases
Rising consumer expectations
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APIC FUTURES SUMMIT – 2004APIC FUTURES SUMMIT – 2004Top Healthcare TrendsTop Healthcare Trends
Proliferation of payment systems Unfunded mandates/political gridlock Shift from surgical to Rx interventions Alternative medicine Increasing violence as a public health problem Increasing gap between haves and have nots
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APIC FUTURES SUMMIT – 2004 APIC FUTURES SUMMIT – 2004 Top Healthcare TrendsTop Healthcare Trends
Wild Cards Economic instability Natural disaster Science for evil as well as good
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FUTURES SUMMIT THEMESFUTURES SUMMIT THEMES
•What Could Change the World as We Know It? Existing & Emerging Threats
• Infection Prevention in the Changing Dynamics of Healthcare
•The Future of Infection Prevention & Control
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APIC FUTURES SUMMIT – 2004APIC FUTURES SUMMIT – 2004Infection Prevention in the Changing Dynamics of Healthcare
“Infection control professionals are complicit in boxing themselves in because they still spend an enormous amount of time in the records room and in retrospective data analysis. Some people are comfortable with that, but it is unconscionable.”
–Ken Segel, Pittsburgh Regional Healthcare Initiative
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APIC FUTURES SUMMIT – 2004APIC FUTURES SUMMIT – 2004Infection Prevention in the Changing Dynamics of Healthcare
“A lot of data collection and massaging, which have been a traditional role of ICPs, can be safely and better done by computers. This would allow ICPs to focus on more value-added activities, which would improve the entire healthcare process.”
– Clay Dunagan, MD, VP. Quality, BJC Healthcare
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APIC FUTURES SUMMIT – 2004APIC FUTURES SUMMIT – 2004Infection Prevention in the Changing Dynamics of Healthcare
“It is important to look at the leadership component of infection control. We must transcend the discipline of infection control to embrace the entire organization. It is the leader’s job to make sure that happens.”
– Clay Dunagan, MD, VP. Quality, BJC Healthcare;
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APIC FUTURES SUMMIT – 2004APIC FUTURES SUMMIT – 2004The Future of Infection Prevention & Control
Technology is revolutionizing surveillance. Increasingly care is being delivered outside of
acute care and outside of ICUs, yet that is where we focus most of our surveillance and prevention activities. We must adapt.
– Denise Cardo, MD, Director, DHQP, CDC; Georgian Ellis, VP. Operations, Shands Healthcare
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APIC FUTURES SUMMIT – 2004APIC FUTURES SUMMIT – 2004The Future of Infection Prevention & Control
“We must deemphasize benchmarking. Being better than a bad benchmark is not the same as being good.”
– Denise Cardo, MD, Director, DHQP, CDC
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APIC FUTURES SUMMIT 2004APIC FUTURES SUMMIT 2004Key Themes Prevention is the message
Promote zero tolerance for HAIs and other adverse events
Technology is the enabler
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APIC’S PREFERRED FUTUREAPIC’S PREFERRED FUTURE
By 2012, APIC will be recognized as the leader in infection prevention and control by practitioners, policy makers, healthcare executives and consumers.
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APIC Futures Summit -- 2006
Complete the business case for infection prevention
ICPs as partners in profitability with hospital financial leaders
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APIC Futures Summit -- 2006 “The fact is most hospitals don’t understand the costliness of infections The costs of these preventable infections in both human and economic terms are staggering.”
Richard Shannon, MDChair Dept of
Medicine Allegheny General
Hospital Pittsburgh
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APIC Futures Summit--2006“Professionals in infection prevention must learn the business of health care—and preventing infection and adverse outcomes for those who entrust us with their lives and the lives of their loved ones is our core business.”
Denise Murphy, RN, BSN, MPH, CIC
VP of Safety and QualityBarnes Jewish HospitalSt Louis
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APIC Futures Summit -- 2007
Participatory Management at all levels of the patient care experience
Reciprocal Responsibility
Incorporating infection prevention into each task
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TSICP
Board convened in January
A new image? A new name to better reflect the
changing focus of our professionUpdate means of communicationRevise the fundamental and intermediate
courses
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TSICP
Education for Texas ICPs on mandatroy reporting
Developing strategic goals for the next 5 years
Creating our future
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APIC VISION 2012
Goal #1: Zero Tolerance
APIC will emphasize prevention and promote zero tolerance for healthcare-associated infections and other adverse events.
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APIC Vision 2012
Goal #1APIC activities:Protect Our Patients Visitor Education
ProgramMonthly Heroes Press releasePromotion of IHI Hand Hygiene Tool KitGrand Rounds in Infection PreventionFree Webinars –best practice
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TSICP
Advisory Panel
Interventionist
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Putting Goal # 1 into Your Practice
ICPs are Patient Safety Advocates
“Prevention is Primary” (CDC)
Interventionist
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Putting Goal #1 into Your Practice
Go and Observe
Investigate in Real Time (RCA)
Rick Shannon, MD
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APIC VISION 2012
Goal #2: Setting the Standard
APIC will ensure that appropriate standards are set by which infection prevention and control programs are evaluated by regulatory agencies, healthcare executives, payers and others.
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APIC Vision 2012
Goal #2
APIC activities: Economics of Infection Prevention Futures Summit NQF development of standardized measures for
reporting Tool kit Cultivate relationships
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TSICP
Cultivate relationships
“Texas-specific” infection prevention and control needs
Education on mandatory reporting
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Putting Goal # 2 into Your Practice
Become active in legislative issues
Develop a rapport with leaders within your organizations
Demonstrate cost effectiveness of the Infection Prevention and Control Program by building the business model
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APIC VISION 2012APIC VISION 2012 Goal #3: A Separate & Distinct Profession
Infection prevention and control will be recognized as a separate and distinct profession, whose members are positioned for leadership roles in healthcare.
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APIC Vision 2012
Goal #3
APIC activities:Business case for infection prevention and
controlSalary and reporting structure survey
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TSICP
Fundamental and Intermediate courses
Annual conference that addresses current issues for the ICP in Texas
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Putting Goal # 3 into Your Practice
Develop a plan to acquire the skills to become a leader within your organization
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Putting Goal #3 into Your Practice
“You have to learn how to learn how to learn.”
Thomas Friedman, columnist, C-Span interview 2005
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APIC VISION 2012APIC VISION 2012 Goal #4: A Catalyst for Leading Edge Research
APIC will serve as a catalyst for leading edge research for the prevention of infection and associated adverse outcomes.
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APIC Vision 2012
Goal #4
APIC activities:Comparison of data sources for reporting
HAIsPrevalence StudySmall grants
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TSICP
Approach the legislature with evidence-based practices to support our position on an issue
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Putting Goal # 4 into Your Practice
Establish and/or participate in an internal research committee that determines evidence-based practice
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APIC VISION 2012APIC VISION 2012 Goal #5: Leadership Role in Emergency Preparedness
APIC will play a leadership role in emergency preparedness related to infection prevention and control including emerging and reemerging diseases, bioterrorism, natural disasters and other issues.
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APIC Vision 2012
Goal #5
APIC activities:Participation in Coalition on Pandemic
PreparednessParticipation in Congressional Hearing on
Pandemic PreparednessCDC/APIC e-learning modules
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TSICP
Emergency planning in Texas
Drills
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Putting Goal # 5 into Your Practice
Participation in emergency preparedness at the local, state, federal level as well as worldwide.
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APIC Futures Summit--2006“Professionals in infection prevention must learn the business of health care—and preventing infection and adverse outcomes for those who entrust us with their lives and the lives of their loved ones is our core business.”
Denise Murphy, RN, BSN, MPH, CIC
VP of Safety and QualityBarnes Jewish HospitalSt Louis
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APIC FUTURES SUMMIT – 2004APIC FUTURES SUMMIT – 2004Infection Prevention in the Changing Dynamics of Healthcare
ICPs’ core competence should be the creation and oversight of learning systems that are necessary for sustainable and constant improvement.
– Clay Dunagan, MD, VP. Quality, BJC Healthcare;
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Collaboration across the Continuum
Model for success—SiouxlandScreen for VREDynamic health department infrastructureTask force efforts
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The Infection Prevention Professional
InterventionistCollect data
Analyze data
Introduce intervention
Measure success
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Interventional Infection Prevention and Control
Education and performance improvement* on CVC-BSI
Before Intervention After Intervention 2.4 0.8
*Revised hospital policy, standardized catheter insertion technique, site care & infection prevention interventions
Eggiman P, et al. Lancet 2000;355:1864-8
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Infection Prevention Professional Role
Patient safety advocate
Healthcare worker safety advocate
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Zero Tolerance
Relationships
Collaboration
Networking
Compromise
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Objectives
1. Recognize the value TSICP and APIC provide for the individual ICP.
2. Discuss the strategic role members of TSICP and APIC contribute to infection prevention and control systems that promote zero tolerance and safe patient care.
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“Delivering safe patient care is not convenient”
Sir Liam Donaldson
Chief Medical Officer, UK
Chair, WHO World Alliance for Patient Safety
August 2005