These are challenging and changing times for infection control in Australia, write Cathryn Murphy and Deborough MacBeth.
Every day in Australia dedicated, specialised and skilled individuals working in a range of settings where health care is planned, delivered and evaluated strive to improve patient outcomes through the prevention of avoidable infections.
The majority are nurses. They routinely work hand-in-hand with peers from the fields of medical microbiology, infectious diseases and epidemiology. Their work is challenging and it’s changing.
Infection control practitioners (ICPs) have one of the most interesting and rewarding jobs in healthcare. On a regular basis they ensure that relevant regulatory, legislative and accreditation requirements relating to infection control are met. They do this by monitoring the incidence of specific infections within their organisation and ensuring that staff is sufficiently educated, resourced and competent to prevent their own exposure to potentially harmful organisms.
They also ensure that infections are not inadvertently spread to or by staff, patients or visitors within the healthcare setting. To achieve these goals ICPs typically design, implement and evaluate organisational wide infection control programs. Such programs take into account specific organisational characteristics such as the type of clinical and other services provided by the organisation, the nature of known or likely to be encountered infection problem areas and the nature of the typical patient population, for example paediatric, elderly or surgical.
The more demanding and unpredictable aspect of the ICP’s work relates to detecting and responding to outbreaks of infectious disease and mitigating risk associated with serious inadvertent breaches of infection control. Recent examples include events such as the 2003 SARS and 2009 H1N1 global pandemics both of which required enormous response from ICPs all around the world and in every healthcare setting.
Although unpredictable, failures in instrument reprocessing and occupational exposures to infectious disease do occur in healthcare and need to be managed. Along with other professionals the ICP is always involved in the review, mitigation and subsequent prevention of such events.
Preparation for a role as an ICP in Australia varies. Options include working initially as a ward-based infection control liaison or link-nurse where such opportunities exist within an organisation.
Other options include attending infection control specific short courses, seminars, workshops or scientific meetings. A range of these are available from professional, academic and private educational providers.
Participation in the Australian Infection Control Association is another strategy that many ICPs employ to access information and resources, to build professional networks and to maintain awareness of emerging and priority issues for ICP’s generally.
Nurses entering, and those actively participating in the current Australian infection control community will find themselves in the midst of a period of great activity and high excitement. Much of this excitement relates to recent initiatives undertaken by the Australian Commission on Safety and Quality in Health Care. In 2007 the commission identified preventing healthcare associated infections as one of its key priorities. In the subsequent four years, it has actively engaged with many of Australia’s leading ICPs to design and implement a suite of specific, standardised national initiatives and resources.
Nurses interested in better understanding the work of an ICP are encouraged to the commission’s document, An Australian infection prevention and control model for acute hospitals, available at www.safetyandquality.gov.au.
One of AICA’s major initiatives over the past few years is the development of a peer-review credentialing process for ICPs through the AICA Credentialing Committee. This process is designed to identify and acknowledge the advanced ICP. Their skills, knowledge and experience are demonstrated through submission of a professional portfolio supported by a peer review commenting on various aspects of the ICP’s practice. More information is available from the AICA website’s credentialing section.
Although initially slow to embrace the process, the initiative has gained momentum resulting in a tenfold increase in ICPs undertaking the credentialing process over the past 18 months.
Credentialing serves a number of important purposes. It acknowledges the expertise of the individual, it identifies a group of experts for the community and the healthcare industry, and it provides some guidance around a career pathway for beginning ICPs in terms of the skills and knowledge they need to develop along their professional journey. AICA’s credentialing initiatives have provided the groundwork for some of the commission’s activities in terms of accessing ICP expertise and also defining specific needs in relation to clinician capacity building.
Recognising the need to ensure adequate preparation of new ICPs, and support those with more advanced skills, AICA continues to explore education and research opportunities.
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