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Basic Infection Prevention in Ambulatory Care Settings

Learn about routine & non-routine infection prevention challenges. Discover how public health can partner with primary care practices. Explore the IP program outcomes from the CDC.

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Basic Infection Prevention in Ambulatory Care Settings

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  1. CT Public Health Association Annual Meeting October 30, 2017 Basic Infection Prevention in Ambulatory Care Settings Where Public Health Meets Medical Care

  2. Learning Objectives • Describe the practice challenges of routine and non-routine infection prevention in ambulatory care settings. • Describe how public health can partner with the primary care practices, such as Federally Qualified Health Centers, to develop training programs that improve public health. • Discuss how “train the trainer” programs can build capacity for educating public health partners.

  3. Why Infection Prevention? • Overlap between public health and medical care • Increasing concern about spread of emerging infectious diseases • New infections resulting from changes or evolution of existing organisms • Known infections spreading to new geographic areas or populations • Previously unrecognized infections appearing in areas undergoing ecologic transformation • Old infections reemerging as a result of antimicrobial resistance in known agents or breakdowns in public health measures.* *Source CDC https://wwwnc.cdc.gov/eid/page/background-goals

  4. IP Program Partners Organizations • Community Health Center Association of CT • YNHHS Center for Disaster Preparedness and Response • Learning Dynamics, Inc. • Federally Qualified Health Centers across CT Fiscal Sponsor • CT DPH Healthcare Associated Infections Program Subject Matter Experts • Louise-Marie Dembry, MD, FACP: Professor of Medicine and Epidemiology; Director, Hospital Epidemiology at the VA CT Healthcare System • David B. Banach, M.D., M.P.H.: Assistant Professor of Medicine, Head of Infection Prevention and Hospital Epidemiologist, UConn Health

  5. Overview of the Project Process

  6. Major IP Challenges at FQHCs • Access to infection prevention resources and training designed for ambulatory care settings • Time and internal capacity to develop and deliver onsite training • Need to standardize baseline IP knowledge among FQHCs and FQHC staff • Variance in FQHC settings and services offered • Staff turnover • Limited IP resources/equipment

  7. IP Program Learning Objectives • Express the importance of infection prevention • Recognize the general principles of disease transmission • Describe general principles of infection prevention in ambulatory settings • Hand hygiene • Cough etiquette/respiratory hygiene • Basic personal protective equipment (PPE) • Basic decontamination • Basic transmission based precautions • Explain how you will apply the general principles in your work setting in routine and emergency situations

  8. Program Component 1: Online Modules Five online modules, suitable for non-clinical and clinical staff, that take 20 – 30 minutes to complete Foundations of Infection Prevention in the Ambulatory Care Setting Standard Precautions in the Ambulatory Care Setting: The Basics of Hand Hygiene Standard Precautions in the Ambulatory Care Setting: Safe Cough Practices Standard Precautions in the Ambulatory Care Setting: Personal Protective Equipment and Safe Surfaces Transmission-Based Precautions in the Ambulatory Care Setting

  9. Program Component 2: Workplace Trainings Three discussion-based case studies that challenge staff to apply basic IP strategies with serious infectious diseases and explore staff understanding of your facility’s related protocols and policies Created a trainer “toolkit” with step-by-step guidance on delivering the scenarios and IP resources Trained 30+ FQHC IP and clinical staff to deliver the scenario training at their workplaces.

  10. Program Pilot Evaluation Results

  11. Successes and Lessons Learned Successes • Train-the-Trainer delivered to over 35 “trainers” representing 13 FQHCs • Trainings were developed in collaboration with FQHC staff • Trainings provided FQHC IP staff with sustainable & adaptable program • Leveraged FQHCs need for preparedness drills & exercises • Variety of staff attended worksite trainings, including front desk and clinical • CHCACT staff reinforced standard interpretations of the program materials across FQHCs, helping to standardize IP practices • Accessible, free IP training for all ambulatory care settings, not just FQHCs Lessons Learned • Difficult for FQHC staff to set aside time for training, even online modules • Helpful to have CHCACT on-site for trainings to clarify state IP regulations and collect evaluation material

  12. Thank You Kathi Traugh, YSPH kathi.traugh@yale.edu Domina DiBiase, CHCACT DDiBiase@chcact.org @trainpubhealth linkedin.com/company/ new-england-public-health- training-center facebook.com/nephtc

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