As APIC assembles thousands of infection preventionists in Charlotte, NC June 11-13 for its annual conference, an IP with 20 years experience in the rapidly changing field will deliver the 2016 presidential address. Meet Susan A. Dolan, RN, MS, CIC, an IP at Children’s Hospital Colorado in Aurora, and the 2016 president of the Association for Professionals in Infection Control and Epidemiology.
Dolan’s two decades of experience have seen tumultuous change, including public reporting of infections, CMS pay-for-performance, the fading efficacy of antibiotics, and a formidable array of emerging pathogens. Thus it makes sense that Dolan’s first priority is to take stock of the profession as APIC releases the results of its unprecedented “MegaSurvey” at the conference. In the survey, APIC sought input from thousands of IPs on the current state of infection prevention in terms of a broad array of demographics and program measures. Hospital Infection Control & Prevention, talked with Dolan about this and other issues as she prepared to for the conference.
HIC: What are some of goals and issues you bring to the table as APIC president?
Dolan: APIC is a large organization with over 15,000 members. In the role of president I will continue the overarching goals of APIC to prevent infections and save lives, and also to elevate infection prevention as a profession. To do that, there are a few things we need to do in terms of increasing the value of infection preventionists and improving patient safety. One is framing the future, and by that I mean gathering information that is collected through the MegaSurvey that APIC conducted in 2015. This is the first large-scale survey of infection preventionists and it will help us understand who infection preventionists are currently and what their programs look like.
HIC: How will the survey results be used to establish APIC’s plans for the future?
Dolan: It is going to be really helpful to us to understand what resources are currently out there and what resources are needed. The information we will be starting to roll out [will inform] not only IPs, but the public and large organizations on what the status of infection prevention looks like today. The MegaSurvey is really important. It is going to give us industrywide data on the profession and help us shape what the future of infection prevention will look like. So this is a very exciting foundation for our organization and IPs.
HIC: What other major initiatives will you be involved in?
Dolan: Continuing to promote competency and certification. APIC has a goal by 2020 to have 10,000 CICs [certified in infection control]. In order to do that we have to really look strategically at how we can break down barriers to certification. And one of them is through some grants that have been obtained to remove financial barriers for those who lack resources to get certified. The second part is increasing members’ awareness of the value of being certified. The third part of that is recognizing those who currently are certified. Hopefully with those things we will continue to increase certification. We are currently over 6,000 CICs and we are continuing to push toward that important goal of 10,000 by 2020.
Another important piece of infection prevention is competency in addition to certification. We are doing that by continuing to expand our tool chest of resources in ways that are easier to access for our members. Not just through webinars, but online learning resources and bringing training classes to various locations around the country that are geographically suited for travel and less expensive for IPs to go to.
HIC: Healthcare is moving rapidly beyond the hospital and we are seeing more emphasis on infection prevention across the continuum.
Dolan: A large emphasis is being put on educating IPs that are practicing in non-acute care hospitals settings, such as ambulatory surgery and critical access hospitals. A big focus this year is new resources for long-term care. Then also with regard to competency, we need to continue work [to establish a career path]. When you are a new IP, what is the roadmap you should take to become proficient? Then next, what does that proficiency level look like? Lastly, this year we have started our first program for advanced practitioners. So those with experience and qualifications with regard to research, education, publications, speaking engagements — those who have really contributed — can be acknowledged by applying for this status through APIC. We will recognize those that have been contributing significantly to the field of infection prevention.
HIC: We talked to you recently about a partnership APIC is establishing with the Society for Healthcare Epidemiology of America. (See HIC, April 2016.) How is that progressing?
Dolan: We’re real excited because we have put into place a structure. We have a summit meeting with SHEA each year to look at ways we can develop combined leadership training, both for the epidemiologists of the program and the infection preventionists of the program. What should the components of an IP program look like? Then also by doing that to develop the leadership of those teams so they can help define resource needs. They can take that message to their C-suite and advocate for resources. Not necessarily by going in and saying, “We need more money,” but by saying, “Here’s what the program currently looks like, and we can do this and this — but this [amount] is what it is going to take.” We need to help develop that skill set in individuals so they are more effective [negotiating] at that level.
HIC: Ebola really underscored the lack of resources in terms of surge capacity and emerging infections.
Dolan: The other thing that is important to this issue— in terms of Zika virus, Ebola, and these emerging pathogens — is that we are working with American Nurses Association. That really took hold during Ebola and that’s good because the focus is back to the basics. Emphasis will be put on educating frontline nurses on hand hygiene, PPE, standard precautions, and how diseases are transmitted. It started with Ebola and it has really merged now into dealing with emerging pathogens and diseases. Zika virus is another example where it is back to the basics, but we need to be on the frontlines. We don’t need to always be behind our desks putting in data. That’s important, but we need to have the resources so IPs we can be at the frontlines and make a difference. That’s where we are really going to make an impact.
HIC: As we continue to see the full implementation of healthcare reform, is infection prevention still well positioned to benefit from these changes?
Dolan: Yes, definitely. We have been able to be effective at advocating for funding resources that are needed for the CDC and programs at the state level as well. Those are extremely important programs for infection prevention. We have also been effective in helping shape some of the metrics for the future — the various measures that are being included or that are being “sunsetted.” We know we are making improvements and getting there, and we have been effective in driving that change, but IPs are also the ones who best understand why we are not making progress on some of the [healthcare associated infections (HAIs)].
HIC: Yes, the CDC has reported dramatic strides with some HAIs, but others like C. diff and CAUTIs have proven difficult to reduce.
Dolan: That’s an important piece and we are continuing to work with CDC and our federal partners in this effort. We are learning that the definitions that we are using [for some HAIs] need to be changed as we make progress with the preventable infections with [intervention] bundles. Also we are seeing that some HAIs are not preventable by the bundles. How do we address those through the research agenda? We can make a certain amount of improvement to a certain level with the preventable ones, and that’s been a lot of great work by infection preventionists. But now IPs also can understand and provide input to CDC on ways we see where the HAI definitions may not be picking up infections. Tweaking them could help. For the ones that are preventable, [our goal is] to get to zero. For those that are not, we need to help drive the research agenda to figure out how we can prevent those types of infections. The other component that is really important and ties back to our competency work is the continued focus and movement of these measures into non-acute care settings. So these measures can start to have effect in ambulatory surgery centers, critical access hospitals, and specialty hospitals like cancer centers. That, in turn, will shine a light on resources needed in those often under-resourced facilities.