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Discover the reasons why an infection preventionist must be certified, including improved outcomes, higher proficiency, and better control of healthcare-associated infections. Explore supporting evidence and preparation tools for the certification exam.
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Why does an infection preventionist need to be certified?November 2, 2018 • Craig H. Gilliam, BSMT, CIC, FAPIC • Director Infection Prevention • St Jude Children’s Research Hospital • Craig.Gilliam@stjude.org
Why does an infection preventionist need to be certified • No financial conflicts to disclose • Served on CBIC 2008 – 2014 • My opinions don’t expressly represent the policy of CBIC.
Objectives: • What are the characteristics of successful IP applicant? • How is CIC a measure of IP’s proficiency? • Making the case for individual to certify
Why a healthcare worker should certify? • The association between certification and improved outcomes in ICU, Med/Surg, Surgical areas and Oncology • Linked to improved ability manage symptoms, established guidelines knowledge, lower rates of adverse outcomes • Henman et al. AJIC 2015, Vol 43 pp 664-668
Why does an infection preventionist need to be certified • Current responsibilities include: • performing surveillance specific to facility • Developing policies • Implementation and education of best practice • Monitoring compliance with bundles • Reporting to public and government • Oversight of preparedness
Why does an infection preventionist need to be certified • Attaining CIC signifies that an IP is deemed competent to recognize, prevent, and control HAIs. • There is a relationship between successful IP programs and having a certified on staff. • Kalp et al. AJIC 2018 Vol 46 pp 858 - 864
APIC MegaSurvey 4,078 respondents • 47% of individuals were certified • More likely to be certified: • Individuals between 56 – 65 were more likely to be certified • Individuals with greater experience in healthcare • Individuals with employer paid benefit for CIC • Kalp et al. AJIC 2018 Vol 46 pp 858 - 864
APIC MegaSurvey 4,078 respondents • Respondents when CIC certified as expert: • Respondents when non-CIC self reported as proficient: • Identification of infectious disease processes • Preventing/Controlling the transmission of infectious agents • Surveillance and Epidemiologic Investigation • Environment of Care
APIC MegaSurvey 4,078 respondents • Respondents when CIC certified or non-CIC self reported as proficient: • Employee and Occupational Health • Management and communication • Education and research • Cleaning, sterilization, disinfection and asepsis
What is the supporting evidence? • Certified IP has impact on infection rates relative to MDRO. • 180 California hospitals surveyed • Certified IP Director had significantly lower MRSA bloodstream infections. • More valuable than # of IP per 100 beds • Pogorzelska et al. AJIC 2012, Vol 40 pp 96-101
What is the supporting evidence? • Perception the evidence for supporting infection prevention implementation stronger than non-certified IP • 703 US hospitals surveyed • CAUTI, CLABSI, VAP, general IP practices • Saint et al. AJIC 2013, Vol 41 pp 100 - 106
What is the supporting evidence? • A 2 fold increase in odds of reporting evidence for antimicrobial stewardship program • A 2 fold increase evidence for nurse initiated discontinue of urinary catheter • 40% decrease in understanding risk of routine CVC changes • Saint et al. AJIC 2013, Vol 41 pp 100 - 106
What is the supporting evidence? • A survey of IP to assess 5 program areas related to immunization • 1000 responses from 2011 • Assessing performance, respondents who are CIC scored significantly higher in overall program performance • Carrico et al. AJIC 2013, Vol 41 pp 581-584
Why does an infection preventionist need to be certified • Part of the job qualification for IP (or within 2 years of employment) competency • May be required for leadership position • TJC may ask about CIC as part of program competency • Points on national surveys – USN&WR
Objectives for CBIC – 10,000 by 2020 • Approximately 65% of 1st time applicants are successful (2015 data) • In 2016 94% of recertification applicants were successful
CIC Preparation • Identification of infectious disease processes (22 items) • Preventing/Controlling the transmission of infectious agents (25 items) • Surveillance and Epidemiologic Investigation (24 items) • Employee/Occupational Health (11 items) • Management and communication (13 items) • Cleaning, Sterilization, disinfection, Asepsis (15 items) • Education and Research (11 items) • Environment of Care (14 items)
CIC Preparation tools to prepare • Each item (question) on the examination will target different cognitive levels. • These levels are: • Recall – a gram stain result is positive – the color of microorganism is purple or pink or red? • Application – a patient with pertussis is placed on what type of precautions – Droplet or airborne or contact? • Analysis – a bacterium that can grow in absence of oxygen but is also able to use oxygen for growth is a facultative anaerobe. An example would be Staphylococcus or Fusobacterium or Influenzae?
CIC Preparation tools to prepare • Each item (question) on the examination will target different cognitive levels. • These levels are: • Recall – a gram stain result is positive – the color of microorganism is purple or pink or red? • Application – a patient with pertussis is placed on what type of precautions – Droplet or airborne or contact? • Analysis – a bacterium that can grow in absence of oxygen but is also able to use oxygen for growth is a facultative anaerobe. An example would be Staphylococcus or Fusobacterium or Influenzae
CIC Preparation tools to prepare • The CIC exam consist of 150 multiple choice questions with 135 scored. Fifteen are in pretest for evaluation. • CBIC recommends reviewing the Examination Content Outline in conjunction with the primary and secondary references • APIC sells an exam review guide that they create and publish. The Certification Study Guide, 6th edition
Why does an infection preventionist need to be certified • References, Primary • APIC Text of Infection Control and Epidemiology • Kulich P, Taylor D, eds. The Infection Preventionist’s Guide to the Lab • Heymann, D., ed. Control of Communicable Diseases Manual • Brooks, Kathy. Ready Reference for Microbes References, Secondary • Current Recommendations of the Advisory Committee on Immunization Practices (ACIP). • Current guidelines, standards, and recommendations from CDC, APIC, SHEA, and Public Health Agency of Canada. • Pickering, Larry K, ed. Red Book,
Why does an infection preventionist need to be certified • Measure of competency of the individual professional in complex healthcare settings • An increase in medical literature that certification is necessary to achieve better outcomes and understand current practice recommendations • It is a personal thing to show I am objectively the best!