How do you spell HELP O R I E N T A T I O N Pilot Project for Long Term Care

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How do you spell HELP?O R I E N T A T I O
N!Pilot Project for Long Term Care Infection
Control Professionals CHICA National Conference
Montreal June 3, 2008 Teri Murduff RN BScN
CIC Infection Control Consultant
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(No Transcript)
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• Objective
• To describe the development and implementation of
  an orientation program for ICPs in LTC settings

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• Acknowledgements
• Pam Ritchie Calgary Health Region
• Susan Cooper South Eastern Infection Control
  Network (SEOICN)
• Suzanne Rowland Champlain Infection Control
  Network (CICN)

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Champlain
North Simcoe Muskoka
Southeastern Ontario
Central East
Central West
Waterloo Wellington
Central Region
Toronto Central
Southwest
Mississauga-Halton
Northeastern Ontario
Erie St. Clair
Northwestern Ontario
Central South
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• Our Mandate
• To maximize coordination and integration of
  activities related to the prevention,
  surveillance and control of infectious diseases
  across all health care sectors and for all
  healthcare providers.
• To promote a common approach to infection
  prevention control and utilization of
  best-practices within the region, which will
  include standardization of infection prevention
  and control policies, procedures, protocols and
  surveillance practices.

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• Our Mandate
• To be sufficiently flexible as to accommodate
  regional and health care sectors differences,
  variations and jurisdictions.

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• What Networks are NOT
• Regional Infection Control Networks (RICN) are
  NOT a
• replacement for existing Infection Prevention and
  
• Control programs. Rather, they
• Build on existing resources and expertise
• Provide another resource for information,
  education and support related to infection
  prevention and control
• Facilitate linking the haves and have-nots to
  each other
• Identify the gaps and assist in addressing needs

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• Orientation Idea
• Inspired by CHICA member
• Support of three network coordinators and
  enthusiasm of three network consultants
• Knowledge that LTC is limited in resources
• Financial
• Personnel
• Trained IC professional

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• In Long Term Care
• May be volunteered for the role
• Usually wears more than one hat
• Most often is not considered a full time
  position
• May be a registered nurse or a registered
  practical nurse

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• Challenges
• Availability
• Ability to dedicate time for infection prevention
  and control role/program
• Resources
• Computer skills

• Knowledge
• Basic statistics
• Microbiology
• Infectious diseases
• Epidemiology
• Experience

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• Adult learning is enhanced when
• the learning climate fosters self-esteem and
  interdependence
• peoples expectations are that the learning
  outcomes will have meaning for them and their
  lives
• people have an active role in decision-making,
  planning for the learning experience and
  authority is shared

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• Adult learning is enhanced when
• a synergistic view of knowledge and learning is
  held
• people are given opportunity to work with the
  ideas and the experiences they have in learning
  situations
• learners evaluate their own learning outcomes,
  learning skills and needs for more learning

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• Length of Orientation
• Two weeks of dedicated ½ day sessions
• Flexible may take up to two months
• Big picture networking and mentoring
• Does require self direction and commitment not
  only from individual but also organization

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Schedule Week 1
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Schedule Week 2
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• Pre-Program Self-assessment
• Describe your confidence level at this time with
  respect to communicating with a Unit Supervisor
  on a particular infection control issue that has
  been brought to your attention. E.g. failure to
  immediately isolate a patient with possible MRSA
• How do you feel about making recommendations to
  Senior Administration about closing a unit due to
  an outbreak of diarrhea?
• What are your expectations of the RICN
  Orientation program?
• What do you see as your challenges in the next 3
  months?

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• Organization Tour
• In conjunction with the RICN consultant
• May be able to point out specific events or
  observed concerns

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• Unit Observation
• Opportunity to stand back and really observe
• Provides added audit skills
• Allows to formalize educational needs
• Allows appreciation of physical environment /
  barriers

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• Department Tours
• May be facilitated by RICN consultant
• For example
• Sterile processing
• Laboratory
• Public Health
• Activity Checklist

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Laboratory Activity List
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• Resources
• APIC text
• APIC Infection Control for Long-Term Care
  Facilities-Toolkit Series
• PIDAC Best Practice Manuals
• Respiratory and Enteric Outbreak Guidelines-
  Public Health Division, Ontario, Ministry of
  Health Long Term Care (MOHLTC)
• Association for Professionals in Infection
  Control Epidemiology, Inc.
• Provincial Infectious Diseases Advisory
  Committee, Ontario

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• Resource Binder
• Provided by RICN consultant
• Becomes property of the organization
• Goal to be enhanced and up-dated by each
  organizations Infection Control Department

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• Contact Information
• Organizational Chart
• IPAC staff contact information
• Organization contact information who to call and
  when
• Internal phone list
• After hours contact list

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• General Information
• Orientation schedule
• Required reading APIC text
• Index IPAC policy procedure manual
• Organization policy procedure manual index
  where to find
• Recommended reading list

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• General Information
• Links to important documents
• APIC/CHICA Professional and Practice Standards
• IPAC resource information
• ICP education information
• IPAC program structure information CHAPTER 1 APIC
  text
• Committees/organization memberships and meeting
  schedules

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• Communicable Diseases
• Reportable disease list
• Public Health contact information
• Public Health forms what, how and when to report
• OHA/OMA communicable disease protocols index
  and link
• Protocols for conditions requiring immediate
  attention
• Ontario Hospital Association/Ontario Medical
  Association

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• Surveillance
• Screening forms
• Febrile Respiratory Illness
• Antibiotic Resistant Organisms
• Data collection forms
• Antibiotic Resistant Organisms
• Data collection forms
• Reports
• Clostridium difficile
• Data collection forms
• Definitions
• Reports

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• Outbreak Management Protocols
• ARO
• Outbreak definition
• Protocol
• Enteric
• Outbreak definition
• Protocol
• Respiratory
• Immunization policies
• Outbreak definition
• Protocol

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• Patient Information
• PIDAC/ MOHLTC fact sheets
• RICN fact sheets
• Organization fact sheets

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• Construction
• Links to IPAC Construction resources
• Contractor Instructions (example)
• Preventative Measures Analysis
• Compliance forms

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• Additional Benefits
• Under the guidance and support of RICN consultant
  
• Observe in-service
• Prepare in-service
• Present in-service
• Progress report
• Orientation Activities
• Observations
• Feedback From Trainee
• Suggestions/ Recommendations

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• Post Program Self-assessment
• Describe your confidence level at this time with
  respect to communicating with a Unit Supervisor
  on a particular infection control issue that has
  been brought to your attention. Eg failure to
  immediately isolate a patient with possible MRSA.
• How do you feel about making recommendations to
  Senior Administration about closing a unit due to
  an outbreak of diarrhea?
• Were your expectations of the RICN Orientation
  program not met, met or exceeded?
• What do you see as your challenges in the next 3
  months?

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• How did we choose the ICPs?
• Chose two facilities
• CEICN approached one organization
• Other organization contacted CEICN
• Varied ICP backgrounds
• Supportive administration
• Flexibility to the process
• Openness with CEICN
• Central East Infection Control Network (CEICN)

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• Orientation Evaluation
• Felt confidence had increased
• Felt that administration would take them more
  seriously
• Increased IC knowledge and where to access
  information
• Appreciated someone with experience mentor
• Fine tuned understanding of their IC role
  challenges-didnt feel cloudy anymore

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• Orientation Evaluation
• Provided the learning climate to foster
  self-esteem and interdependence
• Learning outcomes had meaning for them and their
  lives
• Had an active role in decision-making and
  planning for their learning experience
• Authority was shared

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• Orientation Evaluation
• Knowledge and learning was synergistic
• Provided the opportunity to work with ideas and
  experiences they had in a learning situation
• Evaluated their own learning outcomes, learning
  skills and needs for more learning

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• Lessons Learned
• APIC text may be too technical for some
• Dedicating the time and commitment by the
  organization does lead to success
• Recognition to the importance of the IC role
  despite wearing various hats is necessary
• Orientation process does provide the dedicated
  time
• A mentor is essential for success

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• Next Steps
• Some revisions have been made
• Suggest alternate resources
• Support continues from all network coordinators
  and consultants
• Orientation package will continue to be supported
  by RICN staff until further notice
• Province wide advertisement through RICN website
  
• www.ricn.on.ca

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Questions?Thank you!