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The Infection Control Assessment and Response Tool: Is It Useful during an Outbreak?
Poster Abstracts / American Journal of Infection Control 44 (2016) S28-S82
within an Ebola Treatment designated facility. The unit is a five bed, state of the art, lab capable unit to treat patients with suspected or confirmed Ebola and Emerging Infectious diseases including Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV), Avian Influenza, and Extremely Drug resistant Tuberculosis (XDRTB). A core group of volunteers were trained in personal protective equipment, environmental cleaning, waste management, specimen collection and handling. Education strategies included Computer based learning module (CBL), hands on training, and simulation exercises. The team designing training identified that content retention was an issue. The infectious diseases had differing care requirements, incubation periods, and management. The Infection Preventionist on the team created “At-a-glance” guides for staff to utilize as quick reference to basics of care. METHODS: Information collected on each disease included-isolation precautions, symptoms, exposure period, specimen collection, visitor information, patient transport, waste disposal, linen and laundry, environmental cleaning, duration of precautions, patient discharge, employee health considerations, and post mortem care. This information was compiled in table form and standardized order for each disease. Staff was educated on “At-a glance” guides and location. RESULTS: Staff verbalized the guides would reduce anxiety concerning care due to information being available in one page format, easy to locate, and rapidly available with unit activation. CONCLUSIONS: Reports have shown the United States response to Ebola outbreak revealed issues in emerging infectious disease preparedness. Knowledge of that weakness, and our own experience, resulted in the creation of “At-a-glance” guides for emerging infectious diseases. The focus continues to involve staff engagement, core team membership, ongoing training and education, updates to guidelines of care, development of protocols for unit, and drills.
10-239 The Infection Control Assessment and Response Tool: Is It Useful during an Outbreak? Jodi Morgan, RN, BSN, CIC, Infection Control Coordinator, Illinois Department of Public Health; Mary Alice Lavin, RN, MJ, CIC, Project Director, Hektoen Institute, LLC BACKGROUND: Skilled nursing facilities (SNF) are required to have a plan for investigating, controlling, preventing, and documenting infection incidents as well as corrective actions. The Centers for Disease Control and Prevention (CDC) developed an Infection Control Assessment and Response (ICAR) Tool to help state health departments assess the status of infection prevention and control (IPC) efforts in long term care facilities (LTCF). In February 2015, State Health Department officials were notified of an invasive and noninvasive group A streptococcal (GAS) cluster in a SNF that lasted at least 10 months and caused 61 GAS infections, including 13 invasive cases. During the outbreak investigation, the state health department utilized the CDC’s ICAR tool. METHODS: Outbreak assistance was provided by the State Health Department, Local Health Department and CDC. On-site visits were conducted including an initial interview with the infection control nurses (ICN). The ICAR tool was used to assess nine domains of IPC practice. Due to the specific outbreak circumstances, observations focused on hand hygiene, PPE use and wound care. RESULTS: The ICAR assessment tool responses from the ICN were appropriate; however, they did not reflect actual practices observed. Documentation provided, review of policies, observations
S79
and interviews with staff revealed inconsistencies or gaps in 8 of 9 infection prevention and control domains assessed (Table). CONCLUSIONS: Despite regulatory requirements and reported compliance with IPC recommendations, this facility experienced a large, prolonged GAS outbreak. Our experience highlighted the usefulness of the ICAR tool in identifying IPC policy and practice gaps. Although some gaps were not specifically related to the outbreak, the assessment uncovered IPC implementation challenges due to lack of infection prevention knowledge and inconsistencies in practice. In addition, it underscored the value of focused observations and evaluation of IPC practices instead of just performing policy review in an outbreak setting.
10-240 The Michigan Special Pathogen Response Network (SPRN)—Be Prepared for What’s Next Noreen Mollon, MS, CIC, Infection Prevention Consultant, Michigan Department of Health and Human Services; Betty Ann Eash, RN, BSN, CIC, Special Pathogen Response Network Consultant, Michigan Department of Health and Human Services; Kenneth Onye, MPH, Special Pathogen Response Network Consultant, Michigan Department of Health and Human Services; Jennie Finks, DVM, MVPH, Surveillance for HealthcareAssociated and Resistant Pathogens (SHARP) Unit Manager, Michgan Department of Health and Human Services; Linda Scott, RN, BSN, MA, Director, Division of Emergency Preparedness and Response, MI Department of Health and Human Services BACKGROUND: In response to the 2014 West Africa Ebola epidemic, the Michigan Department of Health and Human Services (MDHHS) secured funds to support development of robust infection prevention and control programs via the Michigan Special Pathogen Response Network (SPRN). The goal of the SPRN is to strengthen Michigan’s emergency response to new or emerging public health threats. The SPRN includes MDHHS, Michigan hospitals, life support agencies, local health departments and the regional healthcare coalitions. Guided by a tool developed by the Centers for Disease Control and Prevention (CDC), the SPRN team offers on-site technical assistance (TA) visits to healthcare facilities to strengthen facility preparedness programs. METHODS: An online fillable survey was sent to all hospitals in the state with a response time of one week. The hospitals were to report on their ability to implement guidance, screen/isolate patients, communication protocols, clinical care/support, personal protective equipment (PPE), laboratory testing/specimen transport, environment of care and medical waste management. RESULTS: Ninety-five percent (161/169) of Michigan’s licensed hospitals responded to the survey. Seven hospitals self- identified as treatment facilities, 40 as assessment facilities, spread throughout the state. Thirty-two hospitals requested TA. To date, eight hospitals have received a TA. Common strengths identified were strong infrastructure, staffing, and clinical management. Identified areas for opportunity were PPE and laboratory capabilities. CONCLUSIONS: In the long term the SPRN will provide sustainable training and assistance to close gaps and strengthen infection control capacity at all facilities. Statewide healthcare infrastructure will be better positioned with response plans for the next emerging pathogen in coordination with the overall healthcare emergency preparedness program.
APIC 43rd Annual Educational Conference & International Meeting | Charlotte, NC | June 11-13, 2016
within an Ebola Treatment designated facility. The unit is a five bed, state of the art, lab capable unit to treat patients with suspected or confirmed Ebola and Emerging Infectious diseases including Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV), Avian Influenza, and Extremely Drug resistant Tuberculosis (XDRTB). A core group of volunteers were trained in personal protective equipment, environmental cleaning, waste management, specimen collection and handling. Education strategies included Computer based learning module (CBL), hands on training, and simulation exercises. The team designing training identified that content retention was an issue. The infectious diseases had differing care requirements, incubation periods, and management. The Infection Preventionist on the team created “At-a-glance” guides for staff to utilize as quick reference to basics of care. METHODS: Information collected on each disease included-isolation precautions, symptoms, exposure period, specimen collection, visitor information, patient transport, waste disposal, linen and laundry, environmental cleaning, duration of precautions, patient discharge, employee health considerations, and post mortem care. This information was compiled in table form and standardized order for each disease. Staff was educated on “At-a glance” guides and location. RESULTS: Staff verbalized the guides would reduce anxiety concerning care due to information being available in one page format, easy to locate, and rapidly available with unit activation. CONCLUSIONS: Reports have shown the United States response to Ebola outbreak revealed issues in emerging infectious disease preparedness. Knowledge of that weakness, and our own experience, resulted in the creation of “At-a-glance” guides for emerging infectious diseases. The focus continues to involve staff engagement, core team membership, ongoing training and education, updates to guidelines of care, development of protocols for unit, and drills.
10-239 The Infection Control Assessment and Response Tool: Is It Useful during an Outbreak? Jodi Morgan, RN, BSN, CIC, Infection Control Coordinator, Illinois Department of Public Health; Mary Alice Lavin, RN, MJ, CIC, Project Director, Hektoen Institute, LLC BACKGROUND: Skilled nursing facilities (SNF) are required to have a plan for investigating, controlling, preventing, and documenting infection incidents as well as corrective actions. The Centers for Disease Control and Prevention (CDC) developed an Infection Control Assessment and Response (ICAR) Tool to help state health departments assess the status of infection prevention and control (IPC) efforts in long term care facilities (LTCF). In February 2015, State Health Department officials were notified of an invasive and noninvasive group A streptococcal (GAS) cluster in a SNF that lasted at least 10 months and caused 61 GAS infections, including 13 invasive cases. During the outbreak investigation, the state health department utilized the CDC’s ICAR tool. METHODS: Outbreak assistance was provided by the State Health Department, Local Health Department and CDC. On-site visits were conducted including an initial interview with the infection control nurses (ICN). The ICAR tool was used to assess nine domains of IPC practice. Due to the specific outbreak circumstances, observations focused on hand hygiene, PPE use and wound care. RESULTS: The ICAR assessment tool responses from the ICN were appropriate; however, they did not reflect actual practices observed. Documentation provided, review of policies, observations
S79
and interviews with staff revealed inconsistencies or gaps in 8 of 9 infection prevention and control domains assessed (Table). CONCLUSIONS: Despite regulatory requirements and reported compliance with IPC recommendations, this facility experienced a large, prolonged GAS outbreak. Our experience highlighted the usefulness of the ICAR tool in identifying IPC policy and practice gaps. Although some gaps were not specifically related to the outbreak, the assessment uncovered IPC implementation challenges due to lack of infection prevention knowledge and inconsistencies in practice. In addition, it underscored the value of focused observations and evaluation of IPC practices instead of just performing policy review in an outbreak setting.
10-240 The Michigan Special Pathogen Response Network (SPRN)—Be Prepared for What’s Next Noreen Mollon, MS, CIC, Infection Prevention Consultant, Michigan Department of Health and Human Services; Betty Ann Eash, RN, BSN, CIC, Special Pathogen Response Network Consultant, Michigan Department of Health and Human Services; Kenneth Onye, MPH, Special Pathogen Response Network Consultant, Michigan Department of Health and Human Services; Jennie Finks, DVM, MVPH, Surveillance for HealthcareAssociated and Resistant Pathogens (SHARP) Unit Manager, Michgan Department of Health and Human Services; Linda Scott, RN, BSN, MA, Director, Division of Emergency Preparedness and Response, MI Department of Health and Human Services BACKGROUND: In response to the 2014 West Africa Ebola epidemic, the Michigan Department of Health and Human Services (MDHHS) secured funds to support development of robust infection prevention and control programs via the Michigan Special Pathogen Response Network (SPRN). The goal of the SPRN is to strengthen Michigan’s emergency response to new or emerging public health threats. The SPRN includes MDHHS, Michigan hospitals, life support agencies, local health departments and the regional healthcare coalitions. Guided by a tool developed by the Centers for Disease Control and Prevention (CDC), the SPRN team offers on-site technical assistance (TA) visits to healthcare facilities to strengthen facility preparedness programs. METHODS: An online fillable survey was sent to all hospitals in the state with a response time of one week. The hospitals were to report on their ability to implement guidance, screen/isolate patients, communication protocols, clinical care/support, personal protective equipment (PPE), laboratory testing/specimen transport, environment of care and medical waste management. RESULTS: Ninety-five percent (161/169) of Michigan’s licensed hospitals responded to the survey. Seven hospitals self- identified as treatment facilities, 40 as assessment facilities, spread throughout the state. Thirty-two hospitals requested TA. To date, eight hospitals have received a TA. Common strengths identified were strong infrastructure, staffing, and clinical management. Identified areas for opportunity were PPE and laboratory capabilities. CONCLUSIONS: In the long term the SPRN will provide sustainable training and assistance to close gaps and strengthen infection control capacity at all facilities. Statewide healthcare infrastructure will be better positioned with response plans for the next emerging pathogen in coordination with the overall healthcare emergency preparedness program.
APIC 43rd Annual Educational Conference & International Meeting | Charlotte, NC | June 11-13, 2016