Infection Prevention and Control Competencies for Healthcare Personnel Ruth Carrico PhD RN FSHEA CIC Associate Professor Division of Infectious Diseases University of Louisville

How did she make it through orientation? What needs to happen to enable her to work effectively?

What is Competence? Competence is the acquisition of knowledge skills and abilities at a level of expertise sufficient to be able to perform in an appropriate work setting In healthcare and in the realm of infection prevention, it means that the worker can perform their job responsibilities in a manner that prevents transmission of infection Competence is putting knowledge, skill and ability into action

Practice Competencies Focuses on what is required of personnel in the workplace – Embodies the ability to transfer and apply skills and knowledge to new situations and environments – Integrates knowledge, skills, attitude, and judgment expected of the worker Should be measurable and action oriented

Chain of Transmission Causative agent Reservoir Portal of exit Mode of transmission Portal of entry Susceptible host 5 DOC28578 Rev A 7/12

Listeners Understands Theory Attentive to Detail Applies Knowledge No Clue Healthcare Personnel Qualities

Practice Competencies for Infection Prevention Role of microbes in disease Transmission Precautions Occupational/Employee health-protecting patient Occupational/Employee health-protecting HCW Problem solving Preparedness

Practice Competencies for Infection Prevention Role of microbes in disease – different types of microorganisms (bacteria, viruses, fungi, etc.), and their role in healthcare- associated infections – antimicrobial resistance and its importance in healthcare associated infections. – proper techniques for collecting, handling and transporting of laboratory specimens.

Practice Competencies for Infection Prevention Transmission – links in the chain of infection – transmission routes – role the environment in transmission – principles of asepsis – distinguishes between clean, disinfected, and sterile – describes the difference between a product that cleans and one that disinfects

Practice Competencies for Infection Prevention Precautions – principles of standard precautions – proper hand hygiene – appropriate use of hand hygiene products – categories of transmission-based precautions and when to initiate – verify negative pressure function of a patient environment – appropriate patient placement (e.g., room type, cohorting) – appropriate interventions required during patient transport – appropriate personal protective equipment – how to put on and take off personal protective equipment – fit check (user seal check) of NIOSH-approved respirator – appropriate disposal of personal protective equipment – signs, symptoms and diagnoses that would alert a healthcare worker to initiate transmission-based precautions

Practice Competencies for Infection Prevention Occupational/Employee health-protecting patient – work practices that reduce the risk of infection transmission – healthcare worker participation in immunization programs – staff member with an infectious condition can pose a risk to other healthcare worker, patients, and visitors – signs, symptoms and diagnoses that require absence from work or work restrictions

Practice Competencies for Infection Prevention Occupational/Employee health- protecting HCW – handling and disposal of sharps – appropriate use of safety devices – handle blood and body fluids to prevent exposure – first aid for cut/puncture exposures, or fluid exposures to the eyes, nose or mouth – process for reporting blood/body fluid exposure in the workplace – appropriate disposal of items soaked/saturated with blood/body fluids or other potentially infectious materials. – Regulated waste vs. general trash and the appropriate disposal of each

Practice Competencies for Infection Prevention Problem solving – how to access infection control resources including policies and procedures – own role in infection prevention and control (e.g., recognizing unsafe activities, intervening when breaches in infection control are identified) – practice changes (e.g., altered standard of care) in the event of limited resources

Practice Competencies for Infection Prevention Preparedness – own role in the facility disaster plan. – participation in facility drills and exercises. – practice changes (e.g., altered standard of care) in the event of limited resources

Applying Competencies Safe Injection Practices – Role of microorganisms in disease – Transmission – Precautions – Occupational/Employee health-protecting patient – Occupational/Employee health-protecting HCW – Problem solving – Preparedness

Returning to the Basics What Does the Healthcare Worker Need to Know in Order to Prevent Infection? – How are infections transmitted – Appropriate use of PPE – Appropriate use of hand hygiene – Critical thinking skills – Isolation practices – Patient/family education How to apply this knowledge in their unique practice setting – Applying knowledge during care – Identifying improvement opportunities – Feedback regarding improvement opportunities – Feedback when processes are not working