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
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Are You Connected? –the inspiration
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From long term care to acute care
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
Complicated my life by trying to understand
genome sequencing and contact investigation
Took a peek “Behind the OR Door”
All these and more!!
Whacked some bugs along the way !
“Drilled down on infection prevention in Dental Practices”
Behind the OR Doors: What every IP needs to know
( Presenters: D. Fawcett and J. Spivey)
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Updates
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New AORN Environmental Recommended Practice (RP) is available through the 2014
AORN Perioperative Standards and RPs
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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?
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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
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New terminology
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TERMINAL CLEANING – should be completed daily when the OR and areas are being
used
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Clean and disinfect all exposed surfaces in the OR including wheels and casters
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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
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All high touch surfaces, doors on cabinets, door handles, key boards, etc.
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Similar to cleaning an isolation room on the unit
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More thorough than between OR room cleaning
Surgical Attire
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Recommended Practices (9) under review for 2015-last revised October 2010
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Gold standard for guidance in your facility for surgical attire in perioperative and sterile
procedure areas
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Some RPs included are :
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Stethoscopes should be clean and not worn around the neck George!
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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 semirestricted 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
Infection
Baseline Period
Metric
Measure/Source
5 Year Target
(2013)
Target SIR or Rate
CLABSI*
2006-08
SIR/NHSN
50% reduction
0.50
CAUTI
2009
SIR/NHSN
25% reduction
0.75
SSI
2006-08
SIR/NHSN
25% reduction
0.75
SCIP
2006-08
SCIP
95% adherence
--
MRSA Bacteremia
(Hospital based)
2010-11
SIR/NHSN
25% reduction
0.75
Invasive MRSA
(Population based) *
2007-08
Rate/EIP
50% reduction
13.5 per 100,000
population
C difficile infection
2010-11
SIR/NHSN
30% reduction
0.70
C difficile
hospitalization
2008
Rate/HCUP
30% reduction
8.1 per 1000
hospitalizations
Notes: *Health People 2020 objectives HAI-1 and HAI-2
What the future of HAI surveillance may
hold…
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Decrease burden of data collection and improve definitions
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Electronic surveillance will likely expand
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Definitions with increased reliability and less subjectivity
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Scientific basis for algorithm “indications” for some infections; lab-based
proxies
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NHSN antibiotic use and resistance module -- a step forward
Is our work going to be the same?
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The work is always changing and will continue to change (improve…)
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There is need to collaborate -- Infection Prevention is now beyond the walls
of one’s facility
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We have to embrace opportunities for e-surveillance
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We have to continue to focus on impact
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We should always be part of the solution
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Feds are listening to IPs –- changes in definitions, metrics, implementation of
CMS regs, etc.
So, are you connected?
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It’s About Collaboration!
DOL
ASPE
IHS
NIH
DoD
VA
OSHA
Other Federal
Involvement
HRSA
CMS
U.S. Dept. of Health & Human
Services
ACL
U.S. States
CDC
SMEs
Science/
Academia
APIC/
SHEA
N Non-Feds
Public
Patient
AHRQ
FDA
So, are you connected?
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Multiple and complex challenges for IPs
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As mentioned earlier, infection prevention has gone beyond the hospital walls
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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