Infection prevention: it’s everybody’s business

Often when hospital infection control and prevention experts are presenting or providing education, they will end with the key message “Infection prevention is everybody’s business.”

This message evolved from the realisation that no matter how many infection control nurses you have in a healthcare setting, unless healthcare workers takes it upon themselves to be accountable for their own actions in following infection prevention best practice, all day, every day, then the holes in the swiss cheese will line up (that is to mean something bad will happen, like an infection).

What does it take for an infection to occur?

1 – you need a pathogen
2 – it needs to be in an infectious dose
3 – you need a mode of transmission
4 – you need a portal of entry
4 – you need a vulnerable host

All five of these factors need to be present (holes in the cheese). Remove one of these from the equation, and an infection won’t occur.

Whilst this message may have originally been the domain of hospitals, the current COVID-19 pandemic has taken it to a whole new level, and in the process drawn in most of the population, not only clinicians but also consumers — patients and the community at large.

Suddenly now, everybody is an expert in infection prevention

As a healthcare worker and now researcher who has worked in infection prevention for over 30 years now, I can safely suggest that the pandemic has strapped on a couple of jet rockets to the cause of infection prevention and propelled it to places I never imagined. Suddenly now, everybody is an expert in infection prevention, and if you live in my state of Victoria, not only do we know what a cluster is, we are all now seasoned epidemiologists.

The Australasian College for Infection Prevention and Control (ACIPC) is the peak body for Infection Prevention and Control (IPC) in the Australasian region. Its 1,600 members lead the field of key decision-makers in infection prevention and control and include nurses, physicians, midwives, aged care workers, industry professionals, scientists, academics, educators, policymakers, dentists, veterinarians, beauticians and tattooists.

ACIPC is a member-based organisation and has education as one of its core activities. A flagship of its education program is the ACIPC Foundations of Infection Prevention and Control course that provides a valuable pathway for further learning and is an important resource for those wishing to pursue a career as an Infection Control Professional.

Furthermore, ACIPC also provides credentialing for professionals who wish to become accredited infection prevention and control experts. Credentialing is a self-regulated, peer-review process and pathway whereby professionals demonstrate the necessary knowledge, skills and attributes to achieve quality patient outcomes.

There are three levels of credentialing for infection control professionals: primary, advanced and expert. Qualifications and experience determine the level a person attains, but the system is designed so those commencing at the “primary” level can progress to “expert”.

A panel of existing accredited infection prevention and control experts reviews all applications. They evaluate whether the applicant meets several criteria across five domains: relevant vocation, prerequisites, knowledge, attitude and practice. Criteria include professional qualifications, awards, experience, continuing education, professional activities, and research. Once credentialed, each member must apply for their accreditation again every three years.

… deploy accredited infection prevention and control experts into residential aged care…

This is important in light of the recent special report of the Royal Commission into Aged Care Quality and Safety that made the following recommendation:

The Australian Government should arrange with the States and Territories to deploy accredited infection prevention and control experts into residential aged care homes to provide training, assist with the preparation of outbreak management plans and assist with outbreaks

So why is this important?

By definition, aged care facilities are not considered to be health care facilities, but rather social care settings often designed to mimic a home environment as much as is practicable. This presents some unique infection control challenges, such as numerous communal areas and shared spaces where large groups can gather.

Credentialed infection prevention and control experts in these settings will be responsible for implementing infection prevention programs in these settings which would include outbreak preparedness, education, including the use of PPE, and all other aspects of basic infection prevention. They would be a resource not only for the residents, but also their families and friends.

So if we are to look for any benefits coming from this pandemic, the significant improvement of infection prevention literacy and knowledge in both clinicians and consumers is certainly a major one. It is with quiet delight that I hear friends and family discuss the pros and cons of physical distancing and masks, and never did I imagine that I would see primary school kids lining up to use hand rub as they enter classrooms.

COVID-19 has exposed several generations to the reality of life in a pandemic. Temporary measures have had to be put in place, whilst some, like masks, will gradually be removed, others, like hand rubs, will probably be a part of our lives forever. The lessons to be learned from this pandemic will continue to be revealed for many years to come.

Public messaging comes and goes too! From the outset, “we’re all in this together” has dominated, closely followed by “staying apart keeps us together”, and for Victorians “there’s only four reasons to leave home”.

We all know now how to prevent COVID, and we all know in an environment with no vaccine, a large part of our community remains vulnerable, and the virus does not discriminate. It is incumbent on us all to be accountable and act responsibly.

 “Infection prevention is everybody’s business.”

Portrait of Phillip RussoPhilip Russo is President of the Australasian College for Infection Prevention and Control (ACIPC). He is Director of Nursing Research, Cabrini Health, and Associate Professor, Faculty of Medicine, Nursing and Health Sciences, Monash University. He is an internationally regarded expert in healthcare associated infection prevention, and led the recently completed the Australian National Healthcare Associated Infection Point Prevalence Survey.