iP Newbe

The next outbreak of the unknown

Communication strengthens credibility

By Patti Grant, RN, BSN, MS, CIC, Infection Preventionist, Addison, TX.

Patti Grant, RN, BSN, MS, CIC

It seems an understatement to say healthcare and the public at large, has had a few “unknown” infection scares in recent years. Severe Acute Respiratory Syndrome (SARS) and the 2009 H1N1 swine influenza pandemic are two examples that come to mind. Sure, we know about the epidemiology of these diseases now, but what about when these pathogens were emerging?

If you are fairly new to your infection prevention role, you might have been at the bedside when these events occurred. Was the messaging about these disease processes at the bedside consistent? Did it instill confidence in your ability to prevent transmission from one patient to another or even to yourself? How about not infecting your family and friends? If you were at the bedside, how did your Infection Preventionist (IP) serve your needs as you balanced the undefined infectious threat against the multitude of issues involved in bedside patient care and patient safety?

The reason I ask, is because if you are a new IP, just the thought of the next unknown will occasionally interrupt the learning curve of your new position. You’ve no doubt learned the depth of becoming a successful and functioning IP and the formal training required as you learn about 12 adjacent areas of expertise and work toward your “CIC” (Certified in Infection Control) status. As you grind through the myriad of learning required for just routine IP responsibilities, the nagging issue of the next unknown infectious threat may work itself to the front of your brain and cause at least momentary anxiety.

Whether IP’s admit it or not, there will be another emerging pathogen, be it a novel micro-organism or a new multi-drug resistant version of an existing pathogen. Despite the best planning the event will put a serious strain on any surge capacity you have built into your infection prevention and control program. So how do you plan for the unknown? How will you keep your credibility strong and confusion at a minimum?

Over the years I’ve often been the sole IP for my facility and several concurrent, yet almost mutually exclusive, communication activities that have served me well during the inevitable unknown infectious episode. Here are a few hard-earned lessons:

  • Admit up front that the issue at hand is “emerging” and that no one person or agency has all the answers. It is critical to state the obvious, because the IP can only be as informed as the resources providing epidemiologic updates.
  • Share the website references supplying the updated information: a) The Centers for Disease Control and Prevention Current Outbreak List (http://www.cdc.gov/outbreaks/index.html); and/or The World Health Organization Disease Outbreak News (http://www.who.int/csr/don/en/). It is important to share information, especially when the references you are sharing are credible in and of themselves. This serves several purposes:
  • It shows information is not being hoarded.
  • There are no secrets and information is shared as knowledge is gained about the emerging threat.
  • It provides your healthcare staff with credible references they can share with family and friends. This can offset misinformation people are getting from non-credible sources.

Share how often you will supply updates, even if the answer is “No New Information at this Time.” Tell staff you will keep them informed via e-mail (or a pre-designated location for posting information). This subtle proactive announcement puts you in the driver’s seat and will decrease phone calls and questions from those expecting more frequent updates.

Keep your administrative team updated with succinct meetings, at regular scheduled intervals, that include operational topics of the unknown threat, such as: 1) personal protective equipment issues; b) human resources impact; c) number of potential cases; and, d) most recent ‘solid’ epidemiologic data from creditable sources.

These communications will go far in providing the opportunity to serve your immediate health-care facility and the community at large through dissemination of creditable information in a non-panic format. The uniqueness of the “unknown” is that even though a full-fledged epidemic may not emerge, the effect can be the same. These communication strategies will keep your credibility intact while decreasing repetitive queries for information so you can better meet the overall challenge.