ARE YOU CONNECTED?

APIC Greater New York Professional Development Support Award 2014 Joy Juele-Cesareo RN, BSN, MN, CIC Associate Director Infection Prevention and Control Metropolitan Hospital Center

APIC Chapter Professional Development Support Award ► Expectation from awardees ► IP in transition  From long term care to acute care  Are You Connected? –the inspiration  APIC national conference :workshops, concurrent sessions, poster presentations, ask the experts, oral abstracts provided over 100 learning opportunities for a vast array of the typical or unique or complex infection control issues  “Disclosures”

I went to APIC 2014 and ….did what??? Learned how to eat banana the right way Took a peek “Behind the OR Door” Whacked some bugs along the way ! Complicated my life by trying to understand genome sequencing and contact investigation “Drilled down on infection prevention in Dental Practices” All these and more!!

Behind the OR Doors: What every IP needs to know ( Presenters: D. Fawcett and J. Spivey)  Updates  New AORN Environmental Recommended Practice (RP) is available through the 2014 AORN Perioperative Standards and RPs  Includes information on what to clean, how to clean, what to use and informative diagrams ( site has a video on how to clean the OR which is a good resource for EVS)  When was the last time you went into the OR?  Change clothes into a scrub attire. Step inside the semi-restricted area in proper attire to gain credibility as an IP

Terminal vs Enhanced Cleaning  New terminology  TERMINAL CLEANING – should be completed daily when the OR and areas are being used  Clean and disinfect all exposed surfaces in the OR including wheels and casters  OR table and mattress, kick buckets, linen hampers  ENHANCED CLEANING – intended to decrease environmental contaminates on high touch surfaces following the care of a surgical patient infected or colonized with an MDRO  All high touch surfaces, doors on cabinets, door handles, key boards, etc.  Similar to cleaning an isolation room on the unit  More thorough than between OR room cleaning

Surgical Attire  Recommended Practices (9) under review for 2015-last revised October 2010  Gold standard for guidance in your facility for surgical attire in perioperative and sterile procedure areas  Some RPs included are :  Stethoscopes should be clean and not worn around the neck George!  Fanny packs, backpacks, briefcases should not be taken into the semi or restricted areas in the OR ► All personnel should cover head and facial hair, including sideburns and the nape of the neck when in the semi- restricted and restricted areas Dr. McDreamy … your IP is watching! ► Health care personnel should receive initial & ongoing education and demonstrate competency on appropriate surgical attire

Federal HAI Initiatives: where we have come from, where we are going, and the importance of inspiring collaboration along the way Dr. D. Cardo, CDC Progress Toward the National Action Plan Targets: Elimination of HAIs in Acute Care Hospitals InfectionBaseline PeriodMetric Measure/Source 5 Year Target (2013) Target SIR or Rate CLABSI* SIR/NHSN50% reduction0.50 CAUTI2009SIR/NHSN25% reduction0.75 SSI SIR/NHSN25% reduction0.75 SCIP SCIP95% adherence -- MRSA Bacteremia (Hospital based) SIR/NHSN25% reduction0.75 Invasive MRSA (Population based) * Rate/EIP50% reduction13.5 per 100,000 population C difficile infection SIR/NHSN30% reduction0.70 C difficile hospitalization 2008Rate/HCUP30% reduction8.1 per 1000 hospitalizations Notes: *Health People 2020 objectives HAI-1 and HAI-2

What the future of HAI surveillance may hold…  Decrease burden of data collection and improve definitions  Electronic surveillance will likely expand  Definitions with increased reliability and less subjectivity  Scientific basis for algorithm “indications” for some infections; lab-based proxies  NHSN antibiotic use and resistance module -- a step forward

Is our work going to be the same?  The work is always changing and will continue to change (improve…)  There is need to collaborate -- Infection Prevention is now beyond the walls of one’s facility  We have to embrace opportunities for e-surveillance  We have to continue to focus on impact  We should always be part of the solution  Feds are listening to IPs –- changes in definitions, metrics, implementation of CMS regs, etc.

So, are you connected?  It’s About Collaboration! U.S. Dept. of Health & Human Services ASPE NIH HRSA ACL FDA AHRQ CDC CMS OSHA IHS Other Federal Involvement N Non-Fed s U.S. States SMEs Science/ Academia APIC/ SHEA Public Patient VA DoD DOL

So, are you connected?  Multiple and complex challenges for IPs  As mentioned earlier, infection prevention has gone beyond the hospital walls  APIC has been a tremendous support connecting member IPs to access to information, networks, and resources

How do I get connected? At this juncture, I think the question that begs to be asked of IPs is: HOW DO I GET CONNECTED?

THANK YOU