By Kelly M. Pyrek
In ICT’s first-ever State of the Industry Report presented earlier this year, survey respondents reported that 77 percent of them participate regularly or frequently in educational events such as conferences, Webinars and self-study courses, in order to improve their knowledge about infection prevention and control.(1) But that leaves the 23 percent who indicated that they rarely engage in education-related activities – are they becoming stagnant in their quest for life-long learning? And approximately one-third of survey respondents pointed to a lack of education as one of the biggest barriers to healthcare workers’ compliance with infection prevention practices.
Many obstacles lie in the path of continuing one’s education, including literacy challenges as well as economic- and time-related factors. In the infection prevention and control profession, it is critical that practitioners stay current because they are the disseminators of essential information relating to proper principles and practice to other healthcare professionals. As part of their jobs in concert with staff development, infection preventionists are expected to assess needs, develop measurable objectives and prepare educational offerings, while applying the principles of adult learning to these educational in-services.(2) Additionally, they are expected to evaluate the effectiveness of education and learner outcomes (such as the compliance rate), as well as instruct patients, families, and other visitors about methods to prevent and control infections.(2) They must also apply their critical reading skills to evaluate research findings and incorporate this information into practice through education and consultation.(2)
Addressing gaps in knowledge is one of the steps toward elimination of healthcare-acquired infections (HAIs) as outlined in a new paper from APIC, SHEA, IDSA and the CDC.(3) In the paper, the authors note, "To develop and to test credible prevention strategies for HAIs, we need to better understand how and why these infections occur. Although there are successful prevention initiatives for some device-associated infections in ICUs, research is still needed to develop evidence-based prevention recommendations for many other HAIs. In some cases, additional research is needed to augment a limited understanding of the basic epidemiology of healthcare-associated pathogens, to inform development of rational prevention strategies. Research is also needed to assess the impact of existing prevention recommendations and policies. Experts in the field propose five phases of translational research to address gaps in knowledge: epidemiologic studies, discovery of potential interventions, evaluating promising interventions leading to the development of evidence-based guidelines, moving evidence-based guidelines into health practice, and evaluating the 'real world' health outcomes of population health practice. The current level of evidence for HAI prevention varies for each type of infection and also by type of healthcare setting."
The quality and quantity of education-related activities in which infection preventionists engage is unique to the individual and commensurate with the practitioner’s level of motivation, desire to learn, and passion about sharing knowledge with others. While myriad educational opportunities present themselves online and in person these days, many infection preventionists are turning to industry-based experts for guidance and instruction.
So what are some of the key areas that infection preventionists have identified as infection prevention-related knowledge gaps that they or that other healthcare workers have?
As Cheryl Pederson, RN, BA, customer education manager for 3M’s Infection Prevention Division, explains, "3M recently hosted a group of experts in all areas of infection prevention for the Infection Prevention Leadership Summit. During the summit, attendees were surveyed and indicated that educating staff on new standards, regulations, technologies and best practices was a challenge in addition to supporting all other infection preventionists’ responsibilities and priorities. The infection preventionists surveyed also expressed a need for more education in the areas of operating room protocols as well as sterilization and endoscopy processing recommended practices."
Wava Truscott, PhD, MBA, director of scientific affairs and clinical education in the Medical Sciences Department of Kimberly-Clark Health Care, points to the persistence of pathogens as a knowledge gap and notes, "Areas that have only recently resurfaced as potentially important reservoirs for nosocomial pathogen transmission include contaminated apparel and environmental surfaces. At first glance that may seem like a boring or even ridiculous statement, but when it is joined with the fact that many microorganisms survive on these surfaces for a very long time. For example, Staphylococcus (including MRSA) can survive on dry surfaces for seven days to seven months, Enterococcus (including VRE) for up to four months, Acinetobacter up to five months, Clostridium difficile spores five months or longer, and norovirus for many months. On textiles, MRSA can survive for seven weeks on the cotton-polyester fabric of lab coats and VRE can survive for four months."
Truscott says that another area that has become a concern is the inadequacy of healthcare cleaning and disinfection practices and techniques. "For example few facilities realize that the use of cotton rags and paper towels with hypochlorite (bleach) solutions, quaternary ammonium compounds (quats), hydrogen peroxides and several other disinfectants significantly reduces their effectiveness," Truscott explains. "Nor do very many realize how much harder some microorganisms are to kill than others. For instance, influenza and hepatitis viruses (enveloped) are easily destroyed with just detergent and water, while norovirus and papilloma virus (non-enveloped) are not even fazed."
Angela Jones, director of marketing for MedMined Services, and Gina Parson, senior manager of infection prevention, both of CareFusion, say, "We are constantly looking for new ways to ensure we provide the most accurate and tailored information to the infection prevention community. For instance, on behalf of ChloraPrep patient preoperative skin prep, we recently conducted a survey of infection preventionists on skin antisepsis best practices and found that there may be a gap between data and guideline recommendations as it relates to clinical practice. With information such as this, we are then able to create tailored educational initiatives to bridge the gaps." Jones and Parson add, " As part of CareFusion’s dedication to making healthcare safer and more productive, educating healthcare workers is a key priority and the company often provides grants and sponsorships to further this education and research. For instance, the speakers programs for ChloraPrep and MedMined™ are something that infection preventionists can use as part of their education efforts. The program offers respected thought leaders in the healthcare community to provide peer-to-peer education on best practices and the most recent data in the fight against HAIs. Similarly, MedMined services, infection surveillance technology from CareFusion, offer healthcare leaders to speak at statewide quarterly educational forums, providing an environment for professional networking and to learn from other industry experts about improving patient safety. In many states, the educational forums are held in partnership with the state hospital association, thereby drawing from their resources. In addition, the ChloraPrep team provides other educational offerings, such as a clinical education theater at medical meeting exhibit booths, in-service DVDs and manuals available online, and a wide array of CME programs focusing on HAIs. Additionally, the ChloraPrep and MedMined services team offer a group of clinical educators that partner with infection preventionists to hold training sessions onsite at the healthcare institution."
