What do Infection Prevention nurses not do! There are a variety of titles that cover our job including Infection Control Practitioner, Infection Prevention Coordinator, and most often the Infection Preventionist, or IP. IPs now come from a variety of backgrounds including nurses, medical technologists, and public health professionals, but the profession has historically been dominated by nurses. In fact, Florence Nightingale is not only viewed as a pioneer of nursing, but also a pioneer of infection prevention and control. A day in the life of an IP is never boring.
What Do Infection Prevention Nurses Do?
The Start of the Day
Most IPs are salary so there is no starting your day at the time clock! With all the unpredictable emergencies that can occur who knows when your day will end (did a kid just come in with measles at 4pm on a Friday?). You may also find yourself coming in at 0530 to catch that operating room morning huddle. The crux of an IP’s job is the infectious disease surveillance across the hospital. This includes, but not limited to, monitoring blood cultures and urine cultures for device associated infections, wound and tissue cultures for possible surgical site infections, and microbiology results in order to identify multi-drug resistant organisms (MDROs) and potential communicable diseases. Potential hospital associated infections (HAIs) are investigated, and infection control measures are put into place if infections are identified that could be spread throughout the hospital.
In infection prevention there are lots of acronyms! Central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), surgical site infection (SSI), ventilator-associated event (VAE). Methicillin-resistant Staph aureus (MRSA), vancomycin-resistant Enterococcus (VRE), carbapenem-resistant Enterobacteriaceae (CRE)…phew! It is almost like speaking another language working in infection prevention, and the basic verbiage and infection criteria utilized among IPs is exactly that. IPs follow definitions of infection developed by the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network (NHSN). This is how infections such as CAUTI and CLABSI are identified among others. Big take away for those who are used to the clinical setting – surveillance definitions do not always correlate with clinical diagnosis! Surveillance is meant to capture trends using standardized criteria, while in the clinical setting diagnoses are focused on the individual. This is a tough concept for those who are clinical and new to IP to comprehend at first.
Policy and Procedure Time
As an IP, you are ultimately responsible (or at least play a major role) in the development of policies and procedures around all things infection prevention. For nursing, this includes topics such as central line and urinary catheter management, as well as standard precautions and transmission-based precautions (don’t you love that yellow gown?). There are also some not so fun policies you may be in charge of – hello operating room attire – but are necessary for regulatory reasons (don’t get me started on the IP’s involvement with The Joint Commission surveys!). Do not be surprised if most days you are asked to review, update, and approve various policies within the hospital.
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There are many fun and rewarding aspects of working in infection prevention as a nurse. You get to know and work with every single department of the hospital. From nursing units to environmental services and plant operations you have a part. It is awesome forming great relationships with all areas of the facility. As an IP, you also get to celebrate the victories such as an intensive care unit going two years without a CLABSI and a potential outbreak successfully avoided. You also get to participate in non-nursey activities such as construction and renovation. Construction dust can harbor mold spores and plumbing work can increase the risk of Legionella, so by default construction in a hospital is a major infection prevention and control activity. How exciting it can be though when you are making friends with construction contractors and climbing across the hospital rooftop in your hard hat and safety goggles!
The Good…But Not so Good
There are of course some not-so-attractive parts of the job of an IP. First, there is lot of time spent managing data and living in Excel spreadsheets. This can be fun at times, but when you break a link in your pivot chart then it can lead to hours of frustration getting items to work. After all that frustration you still have to submit all that data to the CDC and all the other databases that require all the info! Also, unfortunately as the IP you have to put on your “hand hygiene police” hat from time to time and remind people to cover their beverages. It is also not always glorious enforcing and reviewing the daily audits put into place over an infection problem such as CLABSI on a unit or SSI within a specific operating room. Since you are tied to almost every aspect of a functioning hospital, as an IP it is also important to be able to set work boundaries. While people will want to call you for every bug they see or weird smell they smell, not everything is a true infection risk. You must learn to delegate and defer to the appropriate contact. If only everyone treated MRSA like bed bugs! Yet, that may minimize job security for the IP, ha.
Although challenging and a job with a difficult learning curve, working as an Infection Preventionist is always excited and rewarding. You never have the same day, and you are constantly learning. Along with the rest of nursing, you will continue to say to yourself “you can’t make this stuff up” and look to laughter alongside your colleagues. You get to develop amazing relationships with personnel of the hospital you maybe never even knew existed, and, above all else, get to make a huge impact on creating positive outcomes for our patients. Infection prevention and control is an increasingly important field, and the involvement of nurses will continue to be a great importance!
About the Author
Whitney Daum holds her BSN from the University of Akron and her MPH from the University of Colorado. She has worked in the field of nursing for over 10 years. She is certified in both pediatric nursing (CPN) and infection prevention and control (CIC). Whitney is scheduled to graduate with her MSN in Infection Prevention and Control through American Sentinel University in October 2018, and hopes to one day teach new and upcoming nurses the importance of infection prevention.