ARE YOU CONNECTED?

APIC Greater New York

Professional Development Support Award 2014

Joy Juele-Cesareo RN, BSN, MN, CICAssociate Director Infection Prevention and ControlMetropolitan 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 wayDr. 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…

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

FDAAHRQ

CDC

CMS

OSHA

IHS

HAI Prevention Efforts &

HAI Action Plan

Other FederalInvolvement

N Non-Feds

U.S. States

SMEs

Science/Academi

a

APIC/SHEA

Public

Patient

VADoD

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