Organisational
Structure
1. Describe how the infection prevention and
control is organised in health care.
2. List the members of an infection control
team.
3. Outline the topics contained in a typical
infection control manual
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Learning objectives
2
• 45 minutes
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Time involved
3
• Risk prevention for patients and staff is a concern of
everyone in the facility and must be supported at the
level of senior administration
• Infection Prevention and Control Programs require an
appropriate, clear, and firm organisational structure
• Infection Prevention and Control Programs in most
countries are delivered through an Infection Control
Team
• An infection prevention and control manual compiling
recommended instructions and practices for patient care
is an important tool
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Key Points
4
• Each institution is unique and its specific needs
must be considered when developing or
reorganising an infection prevention and control
(IP&C) program
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Introduction
5
National IP&C programs must:
• Set relevant objectives consistent with other national
health care objectives
• Develop and continually update guidelines for health care
surveillance, prevention, and practice
• Develop a national system to monitor selected infections
and assess the effectiveness of interventions
• Harmonise initial and continuing training programs for
health care professionals
• Facilitate access to products essential for hygiene and safety
• Encourage health care establishments to monitor
healthcare-associated infections with feedback to the
professionals concerned
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National Program
6
• Risk prevention for patients and staff is a
concern of everyone in the facility and must be
supported by senior administration
• A yearly work plan should be developed to
assess and promote
•
•
•
•
•
good health care,
appropriate isolation precautions,
sterilisation and other practices,
staff training, and
epidemiological surveillance
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Health Care Facility Programs
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• Appropriate arrangements must be in
place for effective IP&C practices
• There is an Infection Control Committee
(ICC) and an Infection Control Team (ICT)
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Health Care Facility Programs
8
• Provides a forum for multidisciplinary input,
cooperation, and information sharing
• Is responsible for the planning, implementation,
prioritisation, and resource allocation of all
matters relating to IP&C
• Acts as a liaison between departments
responsible for patient care and support services
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Infection Control Committee
(ICC)
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• Chief Executive/Administrator or nominated representative
• Infection Control Officer/Doctor/Microbiologist who may
act as chairperson
• Infection Control Nurse (ICN)
• Infectious Disease Physician (if available)
• Director of Nursing or his/her representative
• Occupational Health Physician (if available)
• Representatives from the major clinical specialties
• Representatives of other departments may be invited as
necessary
• pharmacy, central supply, maintenance, housekeeping, training
services, engineering/design, etc.
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ICC Membership
10
• Holds regular meetings with minutes
• Produces an annual report and an annual
business plan for the program
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ICC Overall Responsibility
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• To review and approve the annual plan for IP&C
• To review and approve IP&C policies
• To support the Infection Control Team and direct
resources to address problems as identified
• To ensure availability of appropriate supplies
needed for IP&C
• To review epidemiological surveillance data and
identify areas for intervention
• To assess and promote improved practice at all
levels
• To ensure staff training in IP&C and safety
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ICC Tasks - 1
12
• To review infectious risks associated with new
technologies and monitor risks of new devices
and products, prior to their approval for use
• To review and provide input into an outbreak
investigation
• To review and approve construction/renovation
projects regarding infection prevention
• To communicate and cooperate with other
committees with common interests, such as
Antibiotic/Pharmacy Committee, Occupational
Health Committee, etc.
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ICC Tasks - 2
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• The team should have a range of expertise
covering
•
•
•
•
•
infection prevention and control
medical microbiology
healthcare epidemiology
infectious diseases
nursing procedures
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Infection Control Team (ICT)
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• Is responsible for the day-to-day running
of Infection Prevention and Control
programs
• Must have appropriate authority
• 24 hour access to the ICT for advice on
IP&C issues is essential
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ICT Responsibilities
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• To develop an annual IP&C plan with clearly defined
objectives
• To develop written policies and procedures, including
regular evaluation and updates
• To prepare an action plan for implementation of the IP&C
program with approval from the Infection Control
Committee
• To monitor and evaluate daily practices of patient care
designed to prevent infection
• To identify problems in the implementation of IP&C
activities which need to be solved or addressed by the
Infection Control Committee
December 1, 2013
ICT Role - 1
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• To organise epidemiological surveillance for
healthcare-associated infections
• To investigate outbreaks and provide data (and
expert advice) that should be evaluated to allow
for any change in practice or allocation of
resources
• To educate all grades of staff in IP&C policy,
practice, and procedures relevant to their own
areas
• To provide advice to all grades of staff on all
aspects of IP&C on a day-to-day basis
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ICT Role - 2
17
• To develop an annual training plan for healthcare
workers and implement IP&C training activities
• To ensure availability of supplies and equipment
needed for IP&C-related activities
• To have a scientific and technical support role in
purchasing and monitoring of equipment and
supplies, and in evaluation and checking the
efficacy of sterilisation and disinfection measures
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ICT Role - 3
18
• To collaborate with the pharmacy and antibiotic
committees in developing a program for
supervising antibiotic use
• To support and participate in research and
assessment programs
• To participate in audit activities
• To obtain program approval from the Infection
Control Committee
• To submit monthly reports on activities to the
Infection Control Committee
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ICT Role - 4
19
• Consists of
• at least one physician, the Infection Control
Officer/Doctor
and
• at least one nurse, the Infection Control Nurse
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Composition of the ICT
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• Is a medically qualified senior staff member who
is interested in and who spends most of his/her
time involved in IP&C
• Typically a medical microbiologist, an
epidemiologist, or an infectious diseases
physician
• May also be called an Infection Control Doctor or
Hospital Epidemiologist
December 1, 2013
Infection Control Officer (ICO) - 1
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• Serves as a specialist advisor and takes a leading
role in the effective functioning of the Infection
Control Team
• Should be an active member of the Infection
Control Committee and may act as its Chair
• Assists the Infection Control Committee in
reviewing annual plans, policies, and long-term
programs for the prevention and control of
infection
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Infection Control Officer - 2
22
• Advises the Chief Executive/Administrator
directly on all aspects of IP&C and on the
implementation of policies and procedures
• Participates in the preparation of tender (bid,
offer) documents for support services and
advises on IP&C aspects
• Must be involved in setting quality standards,
surveillance, and audits with regard to infection
prevention
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Infection Control Officer - 3
23
• Is a registered nurse with an academic education
and practical training which enables him or her
to act as a specialist advisor in all aspects
relating to IP&C
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Infection Control Nurse (ICN)- 1
• Perhaps with a qualification, such as specialised
training
• Is usually the only full-time practitioner on the
Infection Control Team and therefore takes the
key role in day-to-day IP&C activities
• Role may be filled by someone other than a
nurse in some countries. Titles vary.
24
• Contributes to the development and
implementation of policies and procedures,
participates in audits, and monitors tools related
to IP&C and infectious diseases
• Provides specialist-nursing input in the
identification, prevention, monitoring, and
control of infection
• Participates in surveillance and outbreak
investigation activities
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Infection Control Nurse - 2
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• Identifies, investigates and monitors infections,
hazardous practices and procedures
• Participates in preparing documents relating to
service specifications and quality standards
• Participates in training and educational programs
• Is a member of relevant committees where
Infection Prevention and Control input is
required
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Infection Control Nurse - 3
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• These individuals have special responsibility
for maintaining good IPC practices and
education within their departments
• Is the “link” between the Infection Control
Nurse and the ward
• Helps identify problems, implement solutions,
and maintain communications
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Infection Control Link Nurse
(ICLN) - 1
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The ICLN is responsible for:
• Monitoring hygiene, consistent with policies and good
nursing practices
• Monitoring aseptic techniques, including hand hygiene
and use of isolation precautions
• Reporting promptly to the attending physician any
evidence of infection in patients
• Initiating patient isolation/precautions and ordering
culture specimens from any patient
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Infection Control Link Nurse - 2
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The ICLN is responsible for:
• Identifying signs of a communicable disease
when the physician is not available
• Limiting patient exposure to infections from
visitors, staff, other patients, or equipment used
for diagnosis or treatment
• Maintaining a safe and adequate supply of ward
equipment, drugs, and patient care supplies
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Infection Control Link Nurse - 3
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• Establishes standards for performance
• Contains recommended instructions and
practices for patient care
• Topics include:
December 1, 2013
Infection Control Manual - 1
• Patient care
• Hand hygiene
• Isolation precautions practices
• Invasive procedures (intravascular and urinary
catheterisation, mechanical ventilation, tracheostomy
care, and wound management)
• Oral alimentation
30
• Topics include:
• Area specific procedures
• Isolation precautions procedures for infectious patients
• Surgical and operating theatre techniques
• Obstetrical, neonatal, and intensive care techniques
December 1, 2013
Infection Control Manual - 2
• Processing of items of critical importance
• Cleaning, sterilisation, and disinfection
• Medication and preparation of infusions (including blood
products)
31
• Topics include:
• Staff health
• Immunisation
• Post-exposure management for employees, patients, and
others exposed to infectious diseases within the facility
December 1, 2013
Infection Control Manual - 3
• Investigation and management of patients with
specific infections
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•
•
•
•
Methicillin-resistant Staphylococcus aureus (MRSA)
Diarrhoea
Human immunodeficiency virus
Tuberculosis
Multi-resistant Gram-negative bacteria
32
• Ducel G, Fabry J, Nicolle L. Prevention of hospital-acquired infections;
A practical guide, 2nd ed. World Health Organization, Geneva,
Switzerland; 2002; 9.
http://www.who.int/csr/resources/publications/WHO_CDS_CSR_EP
H_2002_12/en/
• Scheckler WE, et al. Requirements for infrastructure and essential
activities of infection control and epidemiology in hospitals: a
consensus panel report. Infect Control Hospital Epidemiol 1998; 19:
114-124. http://www.sheaonline.org/Assets/files/position_papers/IC-Infrastructure98.PDF
• Friedman C, et al. Requirements for infrastructure and essential
activities of infection control and epidemiology in out-of-hospital
settings: A Consensus Panel report. Am J Infect Control 1999; 27(5):
418-430. http://www.ncbi.nlm.nih.gov/pubmed/10530650
• Brannigan ET, Murray E, Holmes A. Where does infection control fit
into a hospital management structure? J Hosp Infect 2009: 73(4):
392-396.
December 1, 2013
References - 1
33
• Essential Resources for Effective Infection Prevention and
Control Programs: A Matter of Patient Safety: A
Discussion Paper – 2010. Public Health Agency of Canada
http://www.phac-aspc.gc.ca/nois-sinp/guide/pssp/index-eng.php
• Friedman C, et al. APIC/CHICA-Canada infection
prevention, control and epidemiology: Professional and
practice standards. Am J Infect Control 2008; 36 (6): 385389. http://www.chica.org/pdf/08PPS.pdf
• Gordts B. Models for the organisation of hospital
infection control and prevention programmes. Clin
Microbiol Infect 2005; 11 Suppl 1:19-23.
December 1, 2013
References - 2
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1. The infection prevention and control program is often
overseen by an Infection Control Committee. T/F?
2. IC link nurses are responsible for:
a)
b)
c)
d)
Day-to-day activities of the IPC program
IC education of all staff
Monitoring local practices
All of the above
December 1, 2013
Quiz
3. An Infection Control Manual helps a facility:
a)
b)
c)
d)
Keep track of its infections
Investigate outbreaks
Establish standards of practice
All of the above
35
• IFIC’s mission is to facilitate international networking in
order to improve the prevention and control of
healthcare associated infections worldwide. It is an
umbrella organisation of societies and associations of
healthcare professionals in infection control and related
fields across the globe .
• The goal of IFIC is to minimise the risk of infection within
healthcare settings through development of a network of
infection control organisations for communication,
consensus building, education and sharing expertise.
• For more information go to http://theific.org/
December 1, 2013
International Federation of
Infection Control
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