Teamwork, along with communication and awareness, can build an effective infection prevention program.
Infection prevention and control is fundamental to providing safe and high-quality patient care. A poor infection control program can result in increased rates of infections, significant illness, and death, and raise the likelihood of multidrug-resistant bacteria.
Awareness is the key to a successful infection prevention (IP) program, says Carol Vance, MSN, RN, PHN, CIC, the multi-site prevention director for Advocate Children’s Hospital in Chicago, a 381-bed facility that is one of the largest network providers of pediatric services in Illinois.
Vance spoke to HealthLeaders about how communication, awareness, and teamwork can contribute to an effective IP program.
This transcript has been lightly edited for brevity and clarity.
HealthLeaders: What are the most common hospital-acquired infections?
Carol Vance: Central line associated bloodstream infections (CLABSIs), along with catheter associated urinary tract infections (CAUTIs) and surgical site infections (SSIs).
HL: What are standard infection control precautions every hospital needs?
Vance: Obviously, hand hygiene is one of the most important things, but I think it's also important to look at things that are not what you hear all the time. There's another component from an executive level that's important, and it’s how those measures are applied and making sure that processes are created with minimal barriers.
An important component is the communication both ways to ensure that if there is some sort of barrier to hand hygiene—a barrier to actually doing the evidence-based bundles—then that is heard by leadership and is actively worked on with the front line to gather to minimize those barriers or challenges.
HL: Can you give an example of how that might apply?
Vance: From a hand hygiene perspective, it might be a situation where the hand hygiene dispensers are in the right place, so when it comes to auditing, it doesn’t take more time for that frontline person to do the right thing.
Also, evaluating the process to do a dressing change or to do anything that is part of the evidence-based bundles. And asking if there is a way to create a better flow that minimizes the extra work to do the right thing.
HL: What else can hospitals do to reduce infections?
Vance: Along with communication, awareness always needs to be top priority and that is challenging when there are so many competing priorities. It involves trying to find what works with the culture of the hospital to create awareness that is every day with every patient and every frontline person and that will look different at each institution.
The core of IP is the same. We know what works; hand hygiene, using the evidence-based practices, making sure your protocols are standardized and they’re easy to replicate. But there's another component to that, especially post-COVID. There's a lot of burnout and additional stress outside and inside the hospital, so communication at all levels is important. Healthcare has had a lot of turnover, and those core components of communication and increasing awareness are vital to get the post-pandemic crew up and running.
Carol Vance, MSN, RN, PHN, CIC
HL: How has the pandemic enhanced safety protocols?
Vance: It was hard on healthcare, but it also allowed healthcare to grow very quickly in certain areas. We learned how important it is to work with our supply chain team members and for systems to work together to get the appropriate personal protective equipment. In the beginning of the pandemic, that was very eye-opening.
There’s also been an enhanced understanding of what isolation precautions are, and the “why” behind them. Due to the fact that hospitals were inundated with COVID patients, they had to understand the “why” behind the PPE and how it can protect them, so it definitely allowed a lot of opportunity for education. It also brought different departments together within the acute care setting to work together on creating processes that helped.
HL: Nurses traditionally have had a large role in infection control. Who else should be responsible for infection prevention?
Vance: We always like to say infection prevention is everyone's role—physicians, respiratory therapists, supply chains. Infection prevention is part of the entire continuum of health.
It is particularly important to make sure each location has the knowledge of infection preventionists; someone who can help translate what the latest guidance is coming out. During the heat of the pandemic, we were gaining all of our knowledge as we went, so it was very important to have an infection preventionist who could decipher and work with the different types of specialty areas—oncology, bone marrow transplant, behavioral health—to navigate and apply it to those areas. Infection prevention is everybody's job, but you need to have that strong IP leader to help answer those questions that the front line may have.
HL: How is your facility doing with IP?
Vance: We are a very large organization, and we have a very strong IP system team. Most hospitals throughout the US took a hit during COVID with an increase in infections, but from an Advocate Aurora standpoint, we talk about infections all the time. It is always on the forefront of discussions: What can we do to improve? How do we share our best practices between hospitals? How do we educate our IPs to ensure that they are truly the experts?
I'm very proud of our system team; the majority of them are all certified and the site IPs share with each other and work collaboratively with the frontline teams. It’s great to see the buy-in, the increased awareness, and putting patient safety first. We have a great process, but we’re always looking to improve and that's important.
HL: What role does technology have in IP?
Vance: Integrating technology to get the front line working with the patient more is always important. They have hand hygiene technology that can give data back on how well each person is doing on hand hygiene.
Also, we do a lot of audits and the one thing that is important is they utilize audit technology to help decrease the amount of steps to get the data. So, if they're doing central line auditing or if they're doing catheter auditing, they can use different types of platforms to have their auditors enter the data and get real-time feedback, and having that real-time feedback is important to make those adjustments.
“We always like to say infection prevention is everyone's role—physicians, respiratory therapists, supply chains. Infection prevention is part of the whole entire continuum of health.”
— Carol Vance, MSN, RN, PHN, CIC, multi-site prevention director, Advocate Children’s Hospital
Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.
A poor infection control program can result in significant illness and death.
Effective infection control processes have minimal barriers.
Infection prevention is everybody's job, but a strong IP leader can best translate the latest guidelines.