Objectives Describe the role of the Infection Preventionist in the - PDF document

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Infection Preventionist: Your Role in the Acute Care Setting Linda R. Greene, RN, MPS,CIC,FAPIC Manager, Infection Prevention UR Highland Hospital Rochester, NY linda_greene@urmc.rochester.edu Objectives  Describe the role of the Infection Preventionist in the Acute Care setting  Discuss changes in the role over the past 10 years  Identify key skills needed for a successful program FHA Mission to Care HIIN 1

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Primary Role Historical Role  Data collector  Reviewed CDC guidelines  Education of staff – focused mainly on nursing  Reported findings to committee What Happened?  Thousands of patients developed HAIs  Many device associated infections  Difference between policy and practice FHA Mission to Care HIIN 2

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Changing Landscape Change Happened  Consumer demands  Press  Resistant organisms and super bugs  Outbreaks with devices and products  Public reporting Media Have Expanded and Rapid Involvement - FHA Mission to Care HIIN 3

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Continuing Emerging Threats  Bioterrorism  Natural disasters  Re-emergence of old diseases or those not prevalent in the U.S. (Measles, Ebola, Pandemic Influenza)  Antibiotic resistance  Candida auris Our Current Perspective HAIs harm patients A large majority can be prevented Consumers are aware of the HAI impact Demand for accountability Infection prevention is mandatory No one of us can do it alone, it takes a Village! IP Competencies Goals:  Connect with science and evidence based practice  Support ongoing role development  Emphasize the importance of certification  Remain relevant across IP’s career span  Apply across all practice settings FHA Mission to Care HIIN 4

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists How About Culture? . Implementation Science  Change in healthcare is needed  We must blend technical information with those social and adaptive skills necessary to bring evidence to the bedside  We will see expansion of these models: CUSP 4 Es Teamwork and Leadership training Change FHA Mission to Care HIIN 5

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Don’t be this… How Do We Create What We Want the Future to Be? FHA Mission to Care HIIN 6

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Culture of Safety What is cultur e? (climate) “The way we do things around here.” One person’s attitude = opinion Everyone’s attitude = culture High Reliability Organization (HRO)  Definition of HRO: Health care organization that functions in a hazardous environment, yet is essentially error-free for long periods of time (Roberts 1990)  Characteristics: organizational commitment to safety high level of backup steps to safety measures strong culture for continuous learning Weick ’02 Key concept: Interdependent teams vs. autonomous individuals Teamwork Disconnect M.D.- “Good teamwork means the nurse does what I say.” R.N.- “Good teamwork means I’m asked for my input.” FHA Mission to Care HIIN 7

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Communication  Complete  Clear  Brief  Timely Tipping Point That magic moment when an idea, trend, or social behavior crosses a threshold, tips, then spreads like wildfire. 3 types of people: Connectors : know tons of people and gladly connect with them Mavens : seek out knowledge and share it with others Salesmen : instinctively garner support Highlights top level commitment  Physician-nurse alignment  Systematic education  Meaningful use of data  Rewards and recognition FHA Mission to Care HIIN 8

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Physicians and RN Collaboration RN rates Physician Physician rates RN % of respondents reporting above adequate teamwork 100 90 93% 90% 88% 80 83% 70 60 59% 50 54% 48% 48% 40 30 20 10 0 L&D RN/OB OR RN/Surgeon ICU RN/MD CRNA/Anesthesiologist Elevation of the Profession Clear Vision and Mission Vision: Healthcare without infection Mission: Create a safer world through prevention of infection Strategic Plan 2020 (pt. safety, implementation science, pt. advocacy, data standardization) Certification is Key Evidence supports certification:  Pogorzelska, Stone, Larson; “Certification in Infection Control Matters” AJIC; 2012 March  Krein; “Preventing ventilator associated pneumonia in the US”;ICHE 2008  Saint; “Preventing hospital acquired urinary tract infection in the US”; Clin Infect Dis; 2008 GOAL: 50% of eligible APIC members FHA Mission to Care HIIN 9

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Future of Certification  Link with institutional job descriptions  Use designation to strengthen role development and professional practice  Levels of practice: novice/advanced/expert Future Changes Future societal changes may include:  Antiaging drugs  Increased prevalence of chronic diseases  Universal medical records carried by every patient  Innovative methods for drug administration  Increased xenotransplantation  Geographic info systems to track pt. and HCW movement Old Skills Won’t Lead to New Outcomes “What Got You Here Won’t Get You There” by Marshall Goldsmith Leadership and Followership skills must be honed Leadership: ability to influence others-essential competency Transactional vs. Transformational Leadership Transactional - specifies roles and tasks; “one size fits all” Transformational - inspires followers to see beyond their self interest Saint/Krein “The only thing constant is change.” Heraclitus FHA Mission to Care HIIN 10

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists New Frontier of Leadership “Know Thyself”  Influence  Self knowledge  Strategic relationships  Reciprocity Manning;ICHE;2010 Followership Kelly identified 5 key types of followers: 1. Alienated (mavericks, cynical) 2. Conformists (“yes” people) 3. Passivists (lack initiative) 4. Exemplary (innovative/independent, willing to question leaders) Human Barriers to Improvement 3 types of staff who present barriers: 1. Active resisters (if it ain’t broke, don’t fix it) 2. Organizational constipators (usually mid to high level execs, disinterested resistors) 3. Timeservers (serving out their time doing the least possible) One ingredient for success is anticipating common barriers! FHA Mission to Care HIIN 11

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Skills Needed “The future is not something we enter . The future is something we create. ” (Sweet) Emerging Knowledge Fields  Organizational dynamics  Data mining  Bioengineering  Social marketing  Health care economics  Green technology  Biomedical ethics Types of Leaders Leadership Behaviors  Designated  Situational Leadership Behaviors  Expert - based on specialized knowledge of task at hand  Facilitative – any member who can manage the process of the team’s work Leadership Repertoire Commanding Pacesetting Visionary Affiliative Democratic Coaching (1) (2) (3) (4) (5) (6) Demands Sets High Mobilized Creates Forges Alignment Develops Modus Immediate Standard for People Towards Harmony and Through People for the Operandi Compliance Performance a Vision Builds Bonds Participation Future People come What do you In a phrase Do what I tell you Do as I do, now Come with me Try this first think? Empathy, Drive to achieve, Drive to achieve, Self confidence, Collaboration, Developing EI building initiative, self- initiative, empathy, team leadership, others, empathy, Competencies relationships, control conscientiousness change catalyst communication self-awareness communication RED / GREEN / Color Energy RED RED / BLUE GREEN •Crisis •Quick results •Change •Heal rifts in a •Build buy-in •Help improve •Kick start from motivated required team •Get input from performance Works Best •Problem and competent •Clear direction •Stressful valuable •Long-term employees team needed situations employees development Adapted from: Primal Leadership: Goleman, Boyatzis & McKee FHA Mission to Care HIIN 12

Infection Prevention Boot Camp for Novice May 30, 2019 Infection Preventionists Effective Leaders  Set clear expectations  Identify priorities  Define who’s accountable  Effectively use all available resources Questions and Group Work Urgent Not Urgent Important Not important FHA Mission to Care HIIN 13