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The infection control practitioner: an action plan for the 1990s.

Some articles have suggested that to survive in the 1990s an infection control practitioner (ICP) will have to be "smarter, brighter, or gone"--they assume that new initiatives for hospital peer review (utilization review, risk management, antibiotic use review, and quality assurance) soon will swallow up the ICP and the infection control program. This article questions that assumption. It reviews data supporting the continuing need for hospital infection control programs and presents information suggesting that the need for the ICP will increase rather than decline during the 1990s. Four essential characteristics for infection control programs are listed, and skills that make the ICP a valuable resource for other peer review programs are described. Several ways that the ICP can (and must) bring this information to the attention of other hospital personnel are suggested. Such actions help assure recognition of the continuing important role of the ICP and the hospital infection control program in each U.S. hospital and long-term care institution.

Communicable Disease Control↗

Role of infection control practitioners in human immunodeficiency virus testing. APIC Bloodborne Pathogens Committee.

BACKGROUND: As a result of the HIV epidemic, the role of the ICP has changed; acute care settings have developed a variety of policies regarding patient and health care worker (HCW) HIV testing and issues related to the HIV-infected HCW. APIC conducted a survey to determine the extent to which ICPs were involved in HCW and patient HIV testing and counseling, the prevalence of routine HIV testing for patients, institutional policies on HIV testing of patients and HCWs, and the management of HIV infected HCWs. METHODS: In 1990, a questionnaire was sent to ICPs in a simple random sample of 1300 acute care hospitals (approximately 20%) in the United States. RESULTS: Response rate was 52.8%. Of the 686 respondents, 54.8% provided counseling to the HCW after an exposure incident. ICPs were involved not only in HIV testing and counseling for patients and HCWs but also in institutional policy development for HIV-related issues. Most facilities (73.8%) obtained written consent for testing from the patient after an employee exposure. When a direct care giver was known to be HIV positive, 61.5% of the respondents evaluated each case individually. CONCLUSIONS: The ICP has a significant role in the development and implementation of institutional policies on HIV testing and counseling and on the management of HIV-infected workers. These findings affirm the need for APIC to provide educational opportunities on the issues related to HIV testing and counseling.

AIDS Serodiagnosis↗

A national task analysis of infection control practitioners, 1982. Part Three: The relationship between hospital size and tasks performed.

One aspect of the Certification Board of Infection Control's (CBIC) task analysis survey was to determine those tasks done most frequently and considered most important by ICPs. A randomized stratified sample of ICPs was taken from U.S. hospitals of various bed-size categories. There were 473 responses (78.8%) from a targeted sample of 600 ICPs. Statistical analyses were done to find if a relationship existed between hospital size and the tasks performed. The frequency of performance and importance of the majority of infection control tasks studied were found to vary in relation to hospital size. Some tasks were found to be both important and frequently performed by the majority of ICPs in all hospital bed-size categories. These included performing and reporting epidemiologic surveillance, educating personnel, developing infection control policies and procedures, and consulting with hospital personnel. Other tasks were found to be relatively less important and infrequently performed by the majority of ICPs in all hospital bed-size categories. These included performing bedside patient care procedures, recommending specific antimicrobial therapy, and using statistical methods. The greatest differences in the performance of tasks were found in the subsample of the ICPs from hospitals with less than or equal to 100 beds.

Communicable Disease Control↗

A national task analysis of infection control practitioners, 1982. Part One: methodology and demography.

A task analysis survey was conducted in 1982 by the Certification Board of Infection Control ( CBIC ) to determine the tasks performed by ICPs and the knowledge and abilities needed to perform these tasks. Data were obtained from 473 (78.8%) respondents to a nationwide mail survey of 600 ICPs . The respondents represent a randomized, stratified sample of ICPs in various types of U.S. acute care hospitals ranging in size from fewer than 50 beds to more than 500 beds. The results of the survey were used, in part, to develop the Infection Control Certification Examination, offered for the first time on November 19, 1983. According to the survey results, the modal or typical ICP is a white woman between the ages of 31 and 50 years using the title of infection control nurse. She has been employed full time for 2 to 10 years in infection control practice in a Joint Commission on Accreditation of Hospitals (JCAH)--accredited community acute care hospital having 301 to 500 beds. She is working at the supervisory level, is on the nursing department payroll, votes as a member of the hospital's infection control committee, and received her last degree or diploma more than 15 years ago.

Adult↗

Intraorganizational influence in the health care setting: a study of strategies preferred by head nurses and infection control practitioners.

BACKGROUND: The purpose of this study was to examine influencing strategy preferences among head nurses (HNs) in the operating room, HNs in critical care and ICPs. METHODS: A 21-item questionnaire on influencing strategy was used to identify 8 dimensions of influence: assertiveness, sanctions, ingratiation, rationality, bargaining, upward appeal, manipulation, and coalitions. The questionnaires were randomly distributed by regional coordinators in nine geographic regions throughout the United States to an operating room HN, a critical care HN, and an ICP at each of 12 hospitals (six with < 250 beds, six with > 250 beds). Two hundred ninety-seven respondents (92%) participated in the study. RESULTS: Although both HNs and ICPs rated rationality (logic, information, and appeal to intelligence) highest as the preferred approach to influence behavior, ICPs rated this dimension significantly higher than both operating room HNs and critical care HNs (p < 0.001). The least preferred strategy among all three groups was sanction (threatening job security). Critical care HNs rated manipulation (threatening to stop working with the other person) significantly higher than did both operating room HNs (p = 0.04) and ICPs (p = 0.01). Age was found to be a factor in the preference for sanctions as an influencing strategy, regardless of specialty: respondents younger than 40 years preferred sanctions less as a means to change behavior than did those older than 40 years (p < 0.01). CONCLUSION: These findings have implications for effective intraorganizational influence in health care settings.

Assertiveness↗