Zero Tolerance: The ICP, TSICP, and APIC

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Zero ToleranceThe ICP, TSICP, and APIC

• Sue Sebazco, RN, BS, CIC
• Infection Prevention/Employee Health Director
• Arlington, TX

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Objectives

• 1. Recognize the value TSICP and APIC provide for
  the individual ICP.
• 2. Discuss the strategic role members of TSICP
  and APIC contribute to infection prevention and
  control systems that promote zero tolerance and
  safe patient care.

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Zero Tolerance

• What is aiming for zero?
• Where did it come from?

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Infection Control in 1972

• Profession the result of Staphylococcus aureus
  pandemic of the 1950s
• The first ICPs
• Early Infection Control Programs

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The ICP in 1980

• Knowledge and Abilities
• Understand nursing procedures
• Isolation technique
• Aseptic technique
• Use of pt care equipment
• Adequate decontamination, disinfection,
  sterilization
• Hospital Infection Control Principles and
  Practices, Mary Castle 1980

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The ICP in 1980

• Knowledge and Abilities
• Microbiology
• Infectious diseases
• Epidemiology
• Administration and Supervision
• Environmental sciences
• Hospital Infection Control Principles and
  Practices, Mary Castle 1980

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APIC FUTURES SUMMIT 2004 What
Happened? More than 50 experts from across the
continuum of healthcare, APIC leaders, and
industry partners convened.
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APIC FUTURES SUMMIT 2004 The Future of
Healthcare Every 30 or 40 years, something
comes along that completely redefines everything
about healthcare. Jeffrey Bauer Healthcare
Futurist
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• APIC FUTURES SUMMIT 2004Top Healthcare Trends
• Molecular medicine
• Digital information technology
• Diversity of society
• Globalization of commerce
• Emergence of new diseases
• Rising consumer expectations

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• APIC FUTURES SUMMIT 2004
• Top Healthcare Trends
• Proliferation of payment systems
• Unfunded mandates/political gridlock
• Shift from surgical to Rx interventions
• Alternative medicine
• Increasing violence as a public health problem
• Increasing gap between haves and have nots

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• APIC FUTURES SUMMIT 2004
• Top Healthcare Trends
• Wild Cards
• Economic instability
• Natural disaster
• Science for evil as well as good

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• FUTURES SUMMIT THEMES
• What Could Change the World as We Know It?
  Existing Emerging Threats
• Infection Prevention in the Changing Dynamics of
  Healthcare
• The Future of Infection Prevention Control

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• APIC FUTURES SUMMIT 2004
• Infection Prevention in the Changing Dynamics of
  Healthcare
• Infection control professionals are complicit in
  boxing themselves in because they still spend an
  enormous amount of time in the records room and
  in retrospective data analysis. Some people are
  comfortable with that, but it is unconscionable.
• Ken Segel, Pittsburgh Regional Healthcare
  Initiative

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• APIC FUTURES SUMMIT 2004
• Infection Prevention in the Changing Dynamics of
  Healthcare
• A lot of data collection and massaging, which
  have been a traditional role of ICPs, can be
  safely and better done by computers. This would
  allow ICPs to focus on more value-added
  activities, which would improve the entire
  healthcare process.
• Clay Dunagan, MD, VP. Quality, BJC Healthcare

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• APIC FUTURES SUMMIT 2004
• Infection Prevention in the Changing Dynamics of
  Healthcare
• It is important to look at the leadership
  component of infection control. We must transcend
  the discipline of infection control to embrace
  the entire organization. It is the leaders job
  to make sure that happens.
• Clay Dunagan, MD, VP. Quality, BJC Healthcare

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• APIC FUTURES SUMMIT 2004
• The Future of Infection Prevention Control
• Technology is revolutionizing surveillance.
• Increasingly care is being delivered outside of
  acute care and outside of ICUs, yet that is
  where we focus most of our surveillance and
  prevention activities. We must adapt.
• Denise Cardo, MD, Director, DHQP, CDC
  Georgian Ellis, VP. Operations, Shands Healthcare

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• APIC FUTURES SUMMIT 2004
• The Future of Infection Prevention Control
• We must deemphasize benchmarking. Being better
  than a bad benchmark is not the same as being
  good.
• Denise Cardo, MD, Director, DHQP, CDC

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• APIC FUTURES SUMMIT 2004
• Key Themes
• Prevention is the message
• Promote zero tolerance for HAIs and other
  adverse events
• Technology is the enabler

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APICS PREFERRED FUTURE By 2012, APIC will
be recognized as the leader in infection
prevention and control by practitioners, policy
makers, healthcare executives and consumers.
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APIC Futures Summit -- 2006

• Complete the business case for infection
  prevention
• ICPs as partners in profitability with hospital
  financial leaders

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APIC Futures Summit -- 2006

• The fact is most hospitals dont understand the
  costliness of infections The costs of these
  preventable infections in both human and economic
  terms are staggering.
• Richard Shannon, MD
• Chair Dept of Medicine
• Allegheny General Hospital
• Pittsburgh

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APIC Futures Summit--2006

• Professionals in infection prevention must learn
  the business of health careand preventing
  infection and adverse outcomes for those who
  entrust us with their lives and the lives of
  their loved ones is our core business.
• Denise Murphy, RN, BSN, MPH, CIC
• VP of Safety and Quality
• Barnes Jewish Hospital
• St Louis

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APIC Futures Summit -- 2007

• Participatory Management at all levels of the
  patient care experience
• Reciprocal Responsibility
• Incorporating infection prevention into each task

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TSICP

• Board convened in January
• A new image
• ? A new name to better reflect the changing focus
  of our profession
• Update means of communication
• Revise the fundamental and intermediate courses

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TSICP

• Education for Texas ICPs on mandatroy reporting
• Developing strategic goals for the next 5 years
• Creating our future

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• APIC VISION 2012
• Goal 1 Zero Tolerance
• APIC will emphasize prevention and promote zero
  tolerance for healthcare-associated infections
  and other adverse events.

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APIC Vision 2012

• Goal 1
• APIC activities
• Protect Our Patients Visitor Education Program
• Monthly Heroes Press release
• Promotion of IHI Hand Hygiene Tool Kit
• Grand Rounds in Infection Prevention
• Free Webinars best practice

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TSICP

• Advisory Panel
• Interventionist

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Putting Goal 1 into Your Practice

• ICPs are Patient Safety Advocates
• Prevention is Primary (CDC)
• Interventionist

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Putting Goal 1 into Your Practice

• Go and Observe
• Investigate in Real Time (RCA)
• Rick Shannon, MD

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APIC VISION 2012 Goal 2 Setting the
Standard APIC will ensure that appropriate
standards are set by which infection prevention
and control programs are evaluated by regulatory
agencies, healthcare executives, payers and
others.
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APIC Vision 2012

• Goal 2
• APIC activities
• Economics of Infection Prevention Futures Summit
• NQF development of standardized measures for
  reporting
• Tool kit
• Cultivate relationships

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TSICP

• Cultivate relationships
• Texas-specific infection prevention and control
  needs
• Education on mandatory reporting

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Putting Goal 2 into Your Practice

• Become active in legislative issues
• Develop a rapport with leaders within your
  organizations
• Demonstrate cost effectiveness of the Infection
  Prevention and Control Program by building the
  business model

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APIC VISION 2012 Goal 3 A Separate
Distinct Profession Infection prevention and
control will be recognized as a separate and
distinct profession, whose members are positioned
for leadership roles in healthcare.
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APIC Vision 2012

• Goal 3
• APIC activities
• Business case for infection prevention and
  control
• Salary and reporting structure survey

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TSICP

• Fundamental and Intermediate courses
• Annual conference that addresses current issues
  for the ICP in Texas

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Putting Goal 3 into Your Practice

• Develop a plan to acquire the skills to become a
  leader within your organization

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Putting Goal 3 into Your Practice

• You have to learn how to learn how to learn.
• Thomas Friedman, columnist, C-Span interview 2005

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APIC VISION 2012 Goal 4 A Catalyst for
Leading Edge Research APIC will serve as a
catalyst for leading edge research for the
prevention of infection and associated adverse
outcomes.
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APIC Vision 2012

• Goal 4
• APIC activities
• Comparison of data sources for reporting HAIs
• Prevalence Study
• Small grants

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TSICP

• Approach the legislature with evidence-based
  practices to support our position on an issue

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Putting Goal 4 into Your Practice

• Establish and/or participate in an internal
  research committee that determines evidence-based
  practice

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APIC VISION 2012 Goal 5 Leadership Role in
Emergency Preparedness APIC will play a
leadership role in emergency preparedness related
to infection prevention and control including
emerging and reemerging diseases, bioterrorism,
natural disasters and other issues.
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APIC Vision 2012

• Goal 5
• APIC activities
• Participation in Coalition on Pandemic
  Preparedness
• Participation in Congressional Hearing on
  Pandemic Preparedness
• CDC/APIC e-learning modules

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TSICP

• Emergency planning in Texas
• Drills

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Putting Goal 5 into Your Practice

• Participation in emergency preparedness at the
  local, state, federal level as well as worldwide.

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APIC Futures Summit--2006

• Professionals in infection prevention must learn
  the business of health careand preventing
  infection and adverse outcomes for those who
  entrust us with their lives and the lives of
  their loved ones is our core business.
• Denise Murphy, RN, BSN, MPH, CIC
• VP of Safety and Quality
• Barnes Jewish Hospital
• St Louis

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• APIC FUTURES SUMMIT 2004
• Infection Prevention in the Changing Dynamics of
  Healthcare
• ICPs core competence should be the creation
  and oversight of learning systems that are
  necessary for sustainable and constant
  improvement.
• Clay Dunagan, MD, VP. Quality, BJC Healthcare

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Collaboration across the Continuum

• Model for successSiouxland
• Screen for VRE
• Dynamic health department infrastructure
• Task force efforts

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The Infection Prevention Professional

• Interventionist
• Collect data
• Analyze data
• Introduce intervention
• Measure success

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Interventional Infection Prevention and Control

• Education and performance improvement on CVC-BSI
• Before Intervention After Intervention
• 2.4 0.8
• Revised hospital policy, standardized catheter
  insertion technique, site care infection
  prevention interventions
• Eggiman P, et al. Lancet 20003551864-8

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Infection Prevention Professional Role

• Patient safety advocate
• Healthcare worker safety advocate

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Zero Tolerance

• Relationships
• Collaboration
• Networking
• Compromise

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Objectives

• 1. Recognize the value TSICP and APIC provide for
  the individual ICP.
• 2. Discuss the strategic role members of TSICP
  and APIC contribute to infection prevention and
  control systems that promote zero tolerance and
  safe patient care.

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Delivering safe patient care is not convenient

• Sir Liam Donaldson
• Chief Medical Officer, UK
• Chair, WHO World Alliance for Patient Safety
• August 2005