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Basic Infection Prevention in Ambulatory Care Settings

CT Public Health Association Annual Meeting October 30, 2017. Basic Infection Prevention in Ambulatory Care Settings. Where Public Health Meets Medical Care. Learning Objectives. Describe the practice challenges of routine and non-routine infection prevention in ambulatory care settings.

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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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