Skills Needed to Advance your career – apic competency model By Lori Schaumleffel, RN, BSN, COHN-S, CIC

APIC Competency Model Objectives: Attendees will be able to identify the four domains of the APIC Competency Model Attendees will be able to identify the three career states in the APIC Competency Model Attendees will be able to identify 3 accredited colleges that offer online Masters in Nursing programs No Disclosures to report

APIC Competency Model The APIC Competency Model was first introduced in AJIC in May 2012 Outlines the skills needed to advance the IP field Directs IP’s professional development at all career stages Traditionally competency has been divided into 2 essential components: knowledge and skill A more recent definition added communication, values, reasoning and teamwork. A standard widely accepted comprehensive definition remains an elusive goal. For most IP’s the elements of competency are defined by a IP job description and may or may not reference national standards or guidelines. For this reason these is widespread variation in what elements and criteria these JD contain

Introduction The model emphasizes those areas that will be essentially critical in the next 3-5 years. Puts Patient Safety at the center The model was designed to be used in combination with organizational training and evaluation tools that are already in place. It puts Patient Safety in the center since it is the aspirational goal for everything else that moves outward from it.

Novice Middle Advanced Stages Identifies 3 Stages of Competency: Early Career/Novice: Has a position where IP is the primary, although not always the sole focus of the role. Earning or has earned a BSN Devolving the skills necessary and studying for the CIC exam Actively acquiring fundamental infection prevention and control skills with an emphasis on learning how to do surveillance and reporting, and the basics of epidemiology and statistics, adult education principles, policy development, and committee planning. They are working to understand and shape their role as an organizational patient safety leader. Mid-Career Proficient: Has earned an undergraduate degree and is often pursuing post-baccalaureate education. See attached reference for help reaching for your Masters Degree May have management or supervisory responsibility Has earned certification and may serve as a mentor to those pursuing the credential. They have a diverse skill set, demonstrate critical thinking and function successfully in a team-based collaborative situations They have further developed and are refining their leadership skills and are effective at managing their IPC programs. They are highly skilled and professionally confident in their roles Advanced/expert Holds a graduate degree Showcases expertise in leadership, management, education, consultation, analysis, and strategic planning The expert promotes certification, mentors others and demonstrates the value of the credential. An accomplished recognized leader in their own organization and beyond. White paper table

Critical areas Four Critical area of expertise needed for the expanding role of the Infection Preventionist Leadership Performance Improvement /Implementation Science Technical Infection Prevention and Control These 4 specific domains represent the areas that APIC identified for future-oriented competency development. Focusing on these 4 strategic developmental domains enables the IP to build on the core competencies and thereby advance his/her career from novice to expert. Progress in the domains is not expected to occur simultaneously nor be maintained at similar levels at all times. For example the IP may demonstrate advanced competency in technical skills, but be less proficient at performance improvement methods. Or they may be an experienced leader yet only have basic technological skills.

Leadership Domain Influence rather than authority Collaboration Followership Program Management Critical Thinking Skills Communication Leadership and Program Management Domain Collaboration As a team member, facilitator or leader of multidisciplinary improvement efforts the IP serves as a Champion for safety culture where prevention of HAI’s is everyone’s responsibility Manages the competing priorities Is a skilled negotiator Team building and consensus building skills are critical As are the ability to influence and persuade Followership As a team member the IP has the ability to provide expertise and exert influence in the absence of authority Program management Alignment of the infection prevention program’s goals with the organizational strategic priorities and annual operating plan is an important responsibility for every IP. Strategic and operations planning and budget management respond to shifts in regulatory and accreditation Respond to the organizations many competing priorities understand the economic environment Critical thinking proficient at understanding, utilizing and synthesizing scientific evidence, including methods for translating evidence into practice Keen interpersonal skills which means being able to inspire, influence, and develop others. Communication – likely the most critical Effective communication takes into account the audience’s informational needs, their cultural background, and knowledge of the subject. Being concise, accurate, and timely in communicating critical information, and identifying barriers are skills taught in conjunction with the science of safety

Infection prevention and control domain Epidemiology and surveillance Risk Assessment Risk Reduction and Infection Prevention Antimicrobial Stewardship Use and interpretation of diagnostic tests Education Research Epidemiology and Surveillance Proficient at applying surveillance definitions – NHSN or McGeer for long-term care And understanding the use of appropriate benchmarks for comparison Able to appropriately review literature Allows a proactive approach to target setting and identification of thresholds that require reaction A basic understanding of statistics and run charts will allow the determination of statistical significance Risk Assessment The IP leads the organization in application and evaluation of basic institutional risk criteria such as that used in hazard vulnerability analysis (eg, current magnitude of the problem, current ability to control the problem, risk to patients) for specific situations and uses relevant data and methods to align the infection prevention plan with the results of the risk assessment. Risk Reduction IPs are involved in reducing infection risk throughout various health care settings. This includes consultative input into the physical design of patient care environments and establishing specifications for protective measures during construction and renovation. IPs also play a key role in the evaluation of new procedures and clinical technologies for patient care. In addition, IPs monitor conformance with care processes that are correlated with decreased infection risk. Use and interpretation of diagnostic tests The IP needs to be familiar with complex testing methods and articulate the advantages and disadvantages of them Antimicrobial stewardship: a inter-professional effort Education: resource for patients and their families, and staff, meet the needs of a diverse work force Research: the IP must be able to critically evaluate research and apply the findings to their practice

Information Technology Support Surveillance Technology Technical Domain Information Technology Support Surveillance Technology Electronic Medical Record (EMR) The rapid escalation in the demand for HAI data highlights the critical need for IPs to use and advocate for standardized, validated, and reproducible data. Managing these critical data will increase demands on the IP To address growing demands for procurement of HAI data as efficiently as possible, better IP knowledge and skills in use of surveillance technology and health informatics will be necessary. Information Technology support Professional and practice standards and elements of board certification in infection prevention assume Preventionists will have access to information technology (IT) hardware and be proficient in use of associated applications (eg, word processing, spreadsheets, presentation and communications applications, the health system intranet). Ability to use internal data bases to access key clinical and administrative data Ability to use external data bases - NHSN Ability to validate the data as correct Surveillance Technology More advanced analytical tools are increasingly important to support surveillance. These include data mining services that use interfaces among laboratory information systems, ADT, pharmacy, and other health information databases. The benefit of this emerging use of IT is reallocation of the preventionist’s time from data entry to intervention strategies aimed at prevention in collaboration with direct care team members. EMR Currently, only 12% of health systems in the United States have a fully functional EMR as defined by key attributes such as computerized provider order-entry and clinical care documentation. Meaningful use

Performance Improvement – implementation science domain Identify opportunities Assemble PI team Tools and methods Implementation Measuring success Performance improvement encompasses all of the systems, projects, and team activities an organization implements to achieve its goals. These goals include the prevention of HAIs for patients, visitors, and staff. Implementation science (IS) is “the scientific study of methods to promote the systematic uptake of clinical research findings and other evidence-based practices into routine practice and hence to improve the quality (effectiveness, reliability, safety, appropriateness, equity, efficiency) of health care. Performance improvement (PI) methods and the principles of IS must be fully integrated into prevention program operations. If PI and infection prevention functions are separated within an organization, there must be sufficient coordination and communication between them to maintain successful partnerships. To accomplish performance/process improvement aimed at reduction of HAIs, the following 5 elements are required: Identification of need for PI the IP is skilled at identifying timely and relevant opport. Assembly of the PI team the IP has the skill to function in several PI roles lead, facilitator, or member Tools and methods (facility specific such as PDCA, Lean, Six Sigma) Implementation – 4 core elements engagement, education, execution, and evaluation Measuring success – baseline comparison of benchmarks, selection of goals with challenging but accessible targets, and process and outcome measures appropriate to the project.

Competency and certification Certification in Infection Prevention and Control (CIC) Strategic Priority for all professionals engaged in Infection Prevention and Control CIC denotes mastery of the fundamental knowledge required for competent performance in the practice

Using the APIC Competency Model Compare your Job Description (JD) to the tool Assess the differences and similarities Use the tool to modify your JD with your stakeholders Can be used to educate others to your expanding role Use for annual goal setting activities Do a self assessment of individual knowledge and skills and compare to the domains and categories Use the model to help inform and guide new IP’s Using a model that is endorsed and accepted by it’s professional constituents, helps to define the professional role to the IP and their stakeholders. APIC views the model as part of the Associations long standing efforts to define and advance the profession.

Questions?