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By Kim Delahanty, RN, BSN, PHN, MBA/HCM, CIC, FAPIC
Within the healthcare arena, infection preventionists (IPs) wear multiple hats. One distinct and very important role is that of a catalyst for positive patient outcomes. One of the ways IPs can affect this patient safety movement is to be active in public health policy around prevention of healthcare-associated infections (HAIs). While IPs perform a variety of functions, collaboration with regulatory and accrediting bodies is key for an effective infection prevention program.
From the novice to the advanced IP there is a place for creating this culture. By being transparent with the regulatory/accrediting agencies only drives the patient safety movement in healthcare closer to our goals of preventable harm. Through local and national Association for Professionals in Infection Prevention and Epidemiology (APIC) chapters, an IP can gain knowledge on how to influence public policy, comply with regulatory/accrediting agencies standards and implement practices of required rules and regulations.
It is imperative to know your local, state and federal regulations as it pertains to infection prevention programs. They vary from state to state and sometimes from city to city. APIC, through their public policy section of their website, has great resources for the IP as it relates to:
• Elimination of healthcare-associated infections
• Antibiotic resistance
• Antibiotic stewardship
• Mandatory influenza vaccination for healthcare personnel
• Using data and information technology to help prevent healthcare-associated infections.
APIC also provides resources and toolkits on how to speak to your local legislators on proposed healthcare-associated infection prevention laws. Voice of the infection preventionist (VIP) list serve is instrumental in keeping the IP educated on current public policy concerns and needs for attention. By having an engaged IP at the legislative level, whether it be local or federal, can impact outcomes of infection prevention public policy laws for the betterment of the patients and employees in healthcare.
This skill does not always come naturally to the IP and may take some education, research and practice on speaking to law makers and regulatory agencies. Some recommendations when dealing with accrediting and or regulatory agencies include but not limited to knowing your surveyors background and experience, do your homework and do not respond unless you are confident with your answer. It is ok to say “I’ll get back to you by such and such a time.”
Not all surveyors and accrediting bodies are alike. For instance, the Joint Commission (TJC) is more of a collaborative educative body. They share best practices from other healthcare institutions as well as borrow from your best practices to share externally. Other regulatory agencies may not subscribe to this philosophy and they may not be there to educate but to investigate. Some, such as the Centers for Disease Control and Prevention (CDC), may be recommending bodies only and not regulatory but just as important to understand and follow. Know which is which. Use your time with novice surveyors to educate them to infection prevention standards, strategies and areas of concern. Brag about your achievements. By preparing ahead of time you will be in a better position to represent your infection prevention program and organization.
Keeping up with the changes in public policy and regulations can be daunting. APIC again does a great job at supporting the local APIC chapters with information on public policy changes including state and federal changes. Their VIP list serve gives real time information for the IP to keep informed. They have a cross-walk of current and past legislation for a reference as well as tips on how to broach the subject with legislators. There is so much to be learned from networking with fellow IPs in your area. They may have some insights on local external agencies and their focal points.
Some other recommendations are to keep current. Set aside time once a month to review public policy events, if your local chapter does not have this as a standing item on their business meeting agenda you may want to suggest it. Stay connected and reach out to a mentor if you are more of a novice IP or unsure of how to start your public policy/regulatory journey. National APIC also can refer you to local mentors in your area.
IPs being at the forefront of HAI prevention legislation will enable the policy makers to do the right things for patients and employees without undue increased burden to the health care landscape. We all will be if we haven’t been already, consumers of healthcare and we all want and deserve to have it done safely regardless of our socioeconomic, ethnic, and religious or sexual orientation status. This investment can and will trickle down to the resident IP and their programs. IPs want legislation that will enhance the patient and employee experience and satisfaction while keeping them safe. Taking the IP away from shoe leather surveillance to do data collection on mundane data harms patients and is an exercise in futility. The data collection and HAI prevention laws need to be purposeful and focused. IPs have a responsibility to educate their legislators so that the HAI prevention laws reflect the current healthcare picture and also drive down preventable harm.
I do not believe healthcare providers wake up and say, “Hey, I want to harm someone today.” Everyone wants to do the right thing for patient/employee safety. By giving meaningful input on HAI prevention strategies to regulatory agencies and partnering with these groups, that can be achievable. IPs are on the forefront of patient safety and the experts driving positive change in healthcare.
Developing communication style for collaborating with internal and external regulatory bodies and accrediting agencies can be tricky. It may not be innate so practicing and doing your research will go a long way in preparing you for those crucial but sometimes difficult conversations.
In closing, the IP must be involved in not only assuring their institutions compliance with existing regulations and standards, but also the development of new laws around preventable healthcare associated infections. Only by doing both can IPs effectively protect patients. Advocate, collaborate, educate, legislate and participate. If you aren’t an APIC member, I suggest you become one.
Kim Delahanty, BSN, PHN, MBA/HCM, CIC, FAPIC, is the administrative director of infection prevention clinical epidemiology at UC San Diego Health.