Infection preventionists play an important role at rural and critical access health care facilities, but they may not have the training they need to be successful and may face barriers to getting that education and support from leaders.
Panelists at an American Medical Association webinar explored the challenges rural IPs face and the resources that can help them keep patients and health care workers safe.
Challenges around infection prevention training
A focus group led by Drs. Ylinne Lynch and Liza Rosenman of the Teaching Infection Prevention through Simulation team at the University of Washington found that many infection preventionists “fell” into the role due to administrative reasons and have a broad range of backgrounds, which can be a benefit. But they didn’t have the tools they needed to be successful. Some reported having to learn on the job, often with little institutional support, leaving them feeling overwhelmed.
Moreover, they reported difficulties getting infection prevention education to appropriate teams, due to misinformation, staff turnover or competing demands. Regardless, they have empathy for clinicians, understanding they face competing priorities, with one participant noting that clinicians are “just trying to get through caring for someone with a higher ratio than normal, and you’re trying to talk about hand hygiene.”
A separate assessment by infection preventionists and registered nurses Lauren Musil and Alisha Sheffield of the University of Nebraska Medical Center found similar challenges. More than 60% of infection preventionists said that they had infection prevention and control training, but only 44% felt it was adequate. On top of that, many have multiple roles, making it difficult to effectively do their job. However, infection preventionists report more job satisfaction if they have the support of hospital leadership, Musil said.
Lynch also touched on that. “I think what’s really hard about [infection prevention and control] is that when it’s done really well, the value’s a little bit invisible,” she said. “You can’t really easily measure the HAIs that are prevented.”
Resources for infection preventionists
The TIPS focus groups found that infection preventionists want more resources to support their efforts. Some participants noted that they needed to create culturally relevant materials or otherwise needed additional guidance to bolster and improve their infection prevention programs.
The IPC Support Center, described by Musil, aims to support such programs by providing tools for IPC education and practice. The center’s Self-led Infection Control Evaluation, or SLICE, tool allows rural and critical access acute care facilities to perform a self-evaluation of their infection prevention programs to identify areas for opportunity. Domains involve environmental cleaning, injection safety and critical device reprocessing, among others, providing resources and immediate summary reports. The center’s “Behind the Mask” webinar series corresponds to the SLICE tool, providing a way to ”reach hundreds of IPs instead of just one IP at a time to answer” pressing questions, Sheffield added.
Other resources within the IPC Support Center include the Extended Reality Education Program, created specifically for sterile processing workflows, giving users the opportunity to become familiar with them before stepping into a processing space. IPs can take advantage of the training by using a headset for an immersive experience, or through a laptop or tablet. The center also has a growing resource repository that includes checklists, audit forms and templates.
Local support
Another resource for IPs is their local Association for Professionals in Infection Control and Epidemiology chapter, where they can connect with other professionals who have similar questions, Sheffield said. Local and state public health departments, as well as health care coalitions, also are resources that IPs can tap in to, and Musil noted that some departments offer office hours specifically for IPs, as well as webinars and infection prevention courses.
Sheffield had more advice for IPs in rural areas: Cold call IP professionals at other facilities to network and collaborate. She added that she has found success by putting herself out there and connecting with others in the field.
Results from the TIPS focus group support the idea of formal and informal networking. Participating IPs said they have shadowed IPs at other facilities and networked to learn how other professionals do their jobs and what worked for them, while others leaned on conferences, webinars and APIC resources.
“There’s lots of support within this community. Everybody’s rooting for one another,” Sheffield said.