2. Patti Grant -- 29th Annual TSICP Conference 2006 Infection Control & Prevention A generic overview of an How Does Infection Prevention & Control fit into “The Big Picture” of our healthcare facility?

3. Patti Grant -- 29th Annual TSICP Conference 2006 Infection Control (Epidemiology)  The Study of Infection Control (IC) is grounded in “Epidemiology”  Epidemiology: The Study of Anything that happens to people  EPI – Upon  DEMOS – People  LOGY -- Study

4. Patti Grant -- 29th Annual TSICP Conference 2006 Where Did IC Come From? Where is IC Prevention Going?  1840’s with Dr. Semmelweis  Handwashing  Germ Theory Cemented 1930’s  Late 1950’s Antibiotics  Early 1960’s Antibiotic Resistance  Back to Handwashing & Prevention  1970: 1 st isolation guideline published by CDC  1992: HICPAC formed to advise DHHS/CDC on infection prevention in healthcare facilities and develop guidelines  Today: Travel, Bioterrorism, Super Bugs, Community Participation

5. Patti Grant -- 29th Annual TSICP Conference 2006 We’re Called Many Things … Even if we “just do” Infection Control  Nurse Epidemiologist  Infection Control Practitioner  Infection Control Professional  Infection Control Coordinator  Infection Control Manager  Infection Control Director

6. Patti Grant -- 29th Annual TSICP Conference 2006 We Work Many Places … Resources are Varied  Large University Teaching Hospital  Non-Teaching Acute Care  For Profit  Non-Profit  Medium & Small Hospitals  Non-Traditional Settings  “Hospital” vs. “Free-Standing” non-hospital affiliated healthcare facilities

7. Patti Grant -- 29th Annual TSICP Conference 2006 Non-Traditional ICP Settings affiliated with Hospitals  Ambulatory Clinics  Day Surgery Centers  Long Term Care Facilities  Rehabilitation Services  Home Care  Dialysis Centers  Transitional Care  Physicians Offices

8. Patti Grant -- 29th Annual TSICP Conference 2006 Setting Determines Resources  Educational Sponsorship?  Hardware? Software?  Data Entry & Secretary Support?  Number “dedicated” to IC & P?  Non Revenue-Producing Department  Multiple Hats?  Risk Management, Employee Health, Nurse Educator, Quality Management, Utilization Review

9. Patti Grant -- 29th Annual TSICP Conference 2006 How is an ICP “Born” ?  APIC -- 1972  LVN, RN, MT, MPH  Formal Training  APIC & State IC Organizations  1-3 years to become ‘proficient’  Ongoing Education  CIC -- 1983  Giving Back: Sustaining the Profession  Research and Publications  Volunteerism  Involvement with Public Policy

10. Patti Grant -- 29th Annual TSICP Conference 2006 Infection Control Human and Fiscal Resources  SENIC Study 1985 1 : ratio of number of ICPs to patient beds 1:250 Acute Care  Before advent of clinics and off-site services, and extensive diversity & complexity of services  Delphi Study 2002 2 : ratio 1:100 (response to expanded responsibilities)  CBIC task analyses of ICP job every 5 years 1982- 2002  Infrastructure consensus recommendations 1998,1999 3  These studies assume “Dedicated ICP” and not a “multi-tasker” (wearing many hats) 1 Haley RW. Am J Epidemiol 1985; 121: 182 2 O’Boyle C. AJIC 2001; 30:321 3 Scheckler WE. ICHE 1998; 19:114; Friedman C. ICHE 1999; 20: 695

11. Patti Grant -- 29th Annual TSICP Conference 2006 Not “JUST” Infection Control  Microbiology  Epidemiology  Statistics  Management  Communications  Employee Health  Reportable Disease  Plant Operations  Education  Sterilization  Disinfection  Patient Care  Infectious Disease  Research Projects  Vendor Decisions  Construction & Renovation Projects

12. Patti Grant -- 29th Annual TSICP Conference 2006 Any IC Decision is Multifaceted  APIC & SHEA  CDC … Can I take my  JCAHO placenta home?  EPA … Can I get AIDS from  OSHA a razor blade that  FDA was in a shoe at the store?  CMS … What refrigerator can I store leeches in?  State & Local Health Department

13. Patti Grant -- 29th Annual TSICP Conference 2006 In a Nutshell? Infection Control:  Conductor of Biohazard Safety  For Patient, Employee, Volunteer, Visitor  Discussion  Conclusion  Recommendation  Action  Follow-Up

14. Patti Grant -- 29th Annual TSICP Conference 2006 Infection Control: The Big Picture  Site Visits (Surveillance Rounds)  Prospective Chart Surveillance  Policy & Procedure  Information Sharing

15. Patti Grant -- 29th Annual TSICP Conference 2006 Examples of “Big Picture” …  September 11, 2001  Bioterrorism Preparedness  Smallpox Vaccine  Anthrax  Ricin  Monkey pox – For Real!  SARS  2004-2005 Flu Vaccine Shortage

16. Patti Grant -- 29th Annual TSICP Conference 2006 Our Public Health Commitment  Extends beyond the hospital  TB Elimination  Meningococcal meningitis  Enteric Pathogens  Emerging Diseases (SARS)  The “OUTSIDE” does and will come in …it is not just business as usual

17. Patti Grant -- 29th Annual TSICP Conference 2006