For more than two decades I have worked in a discipline of disease prevention where the goal was to create a safe environment for employees, patients, visitors and volunteers. Infection control practitioners created policies and practices designed to prevent the transmission of infectious agents from patient to patient, patient to employee and employee to patient. This is the field always known to us in the past as infection control.
Over the last 35 years, the field of infection control has increasingly evolved in the healthcare arena. It started out as an activity in hospitals to control healthcare-acquired infections (HAIs) through mere surveillance activities which reported a number with no substantive action steps to address the risks. Today, leaders in infection control continuously explore emerging research, techniques and technologies to identify new and better ways to reduce the risk of adverse infections and complications for patients and our community. They partner with other regulatory bodies such as the Food and Drug Administration (FDA), the Environmental Protection Agency (EPA), the Joint Commission (JC), and the Centers for Medicare and Medicaid Services (CMS) to create public policy from evidence-based practice to ensure our healthcare facilities are safe. Through these efforts, it is commonplace for leaders in the field to work with policy makers at the state, regional and federal levels and to testify before legislative bodies to explain the significance of combating HAIs in a systematic manner. This creates transparency in an era of increasing mandatory reporting requirements. The goal of infection prevention is to protect the patient, protect the healthcare worker and others inside the work environment and do those things within a low economic burden to hospitals.
Today, consumers see the value in low infection rates. Consumers are aware of the amount of time they may spend in a healthcare facility and expect (as they should) that no harm in the way of infections or any other adverse event will get in their way. Prevention is key, and the Association for Professionals in Infection Control and Epidemiology (APIC), our national organization, is aligning all of its efforts and planning to prevention modes. The primary goal remains to prevent infections in our patients and to protect the spread of infections from patients to healthcare workers.
In our practice, each of us in a leadership role has a responsibility to follow the lead of our organization and implement a “preventionist” approach in our individual environments. So when I became the director of the infection control program at Georgetown University Hospital (GUH) in Washington, D.C., I was given the opportunity to redesign the existing program to a mode of “prevention” versus “control” of infections. The seeds had been planted by very knowledgeable and proactive leaders before me. But now it is my journey to undertake and transform the way infection control is executed. The first thing I did was to change the name of our infection control department to the infection prevention department and the name of our infection control practitioners to infection preventionists. Our senior leaders approved the idea and felt the name sent a message to our patients and consumers that our standard mission was to “prevent” infections from occurring in the first place, not “control” them after the fact. And as preventionists, we recommend scientifically validated practices to our care providers that will significantly reduce the risk of potential harm to patients.
The name change has made a difference and peaked the interest and involvement of healthcare providers at Georgetown. It has sparked an awakening and a renewed interest in what infection prevention is all about. With our new name and new face, we employ efforts that include active surveillance, appropriate precautions, improvement of hand hygiene compliance, revised prevention standards, patient education, continuing education, promotion of immunization for vaccine preventable diseases, involvement in legislative policy decisions and continuing education for all at GUH. The goals of the infection prevention department at GUH are to utilize new technology which will provide indisputable data on contamination, colonization and infections in your patient populations; to work with our care providers to recommend the safest practice to reduce that risk and to follow a “zero-tolerance” protocol. We believe that “zero tolerance” can not be just a slogan—it has to become a way of practice. It means not tolerating mediocre standards, but always doing the right thing, expecting 100 percent compliance at all times.
With our redesign, we are also recruiting for additional infection preventionists and, as with many other facilities, it has been a challenge. I asked our nurse recruiters to change the position advertisement which was formerly advertised as a position for an infection control practitioner to an infection preventionist. Almost immediately, we had several applications from around the country who were intrigued that we had already made the name change—and they wanted to be a part of the vision and transition of an infection prevention approach in healthcare. As a result, we have attracted additional infection preventionists to our budding team very quickly.
With our new name and our focus on prevention, we are spreading the word (and not infections!) that infection prevention is everyone’s responsibility at GUH. The response to the changes of our name and focus on prevention versus control is so significant that we have increased participation in efforts from our nurses, therapists and medical staff. With persistence and a multidisciplinary focus, our message is that through prevention versus control of unsafe outcomes, lives can be saved. We are bringing all employees at GUH to understand that cleanliness of the environment, vigilant hand hygiene, appropriate precautions, right choice, right time antibiotics and an immunized workforce are key to creating a safer environment.
We deliver this prevention message at department meetings, infection prevention committee meetings and in all of our correspondence. It has been amazing to us how a name change can spark such interest and buy in from our team. Mostly, they like the message that it sends to the public. We are telling our community that, at GUH, patients and families can expect every effort will be made to make their stay with us as safe as is humanly possible. That message is vital to our care providers and they know that with each step they take in prevention efforts, they are making a difference in the healthy outcomes of all of our patients.
What’s in a name? Who would have guessed that a simple name change would revive our passion in the field of preventing the transmission of infections? We still have miles to go as we address the endless evolving regulatory mandates. We are about prevention. We are about providing a safe environment for employees, patients, visitors and volunteers. I applaud national APIC for taking the lead with this very simple measure which send s a very loud message. I encourage all facilities to follow suit and change your name to infection preventionists!
Mary M. McNally, RN, MHA, CIC, CHS, is the nurse epidemiologist and director of infection prevention and employee health at Georgetown University Hospital in Washington, D.C. She was previously the director of the Center for Infectious Diseases at Memorial Health University Medical Center, a Level 1 trauma center in Savannah, Ga. She is originally from Massachusetts where she received her BSN from Assumption College in Worcester. She received her master’s in healthcare administration from St. Joseph College in Maine. She has been in infection prevention for 22 years and achieved her certification in 1990. She is also certified in homeland security. McNally is past president of the Coastal Empire Chapter of APIC in Southeast Georgia and past president of the board of directors of the Georgia Infection Prevention Network. In addition, McNally has served on many statewide and community task forces for terrorism preparedness and hospital mutual aid. She moved to the Washington area and Georgetown University Hospital in April 2008.