Infection Control Today

MAR 2019

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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6 ICT March 2019 editor's letter EDITORIAL EDITOR IN CHIEF Kelly M. Pyrek S ALE S/MARK E TING GROUP PUBLISHER William Mulderry PUBLISHER John Currid SUBSCRIPTION CUSTOMER SERVICE 800-581-1811 PRODUC TION ART DIRECTOR Robert Rys AD PRODUCTION MANAGER Bonnie Streit DIRECTOR PUBLICATIONS Joseph Chackola HUMAN RESOURCES DIRECTOR Donna Layton INFORMA E XHIBITIONS LLC 2020 N. Central Ave., Ste. 400 Phoenix, AZ 85004 Phone: 480-867-7943 Web: Infection Control Link Nurses: More Research Needed to Support This Key Role Kelly M. Pyrek Editor in Chief R esearchers have found a lack of robust evidence relating to the practice of improving compliance by involving dedicated nurses known as infection control link nurses (ICLN), who act as a link between their own clinical area and the infection control team and raise awareness of infection prevention and control. As Dekker, et al. (2019) note, "The major investment in time and effort of the infection control team and link nurses that accompanies the implementation of an ICLN program is generally perceived as worthwhile," but they add that before advocating ICLN programs, a better understanding of the use, range and benefi ts of these programs is needed. The researchers conducted a scoping review of the current literature and included 29 papers in their examination. They discovered that ICLN were fi rst described in 1981 as a liaison between the epidemiology department and clinical wards, and that in the following years, the educational role was added. The researchers identifi ed four core themes for the link nurse role: "act as a role model and visible advocate, enable individuals and teams to learn and develop infection prevention and control practice, act as a local communicator, and support in audit and surveillance." Tasks of the link nurse role that were considered viable included: perform surveillance of infections, monitor infection prevention and control practices, aid in the early detection of outbreaks of infection, improve clinical practice at ward level, act as a role model, and assist in research. The core competences of ICNL for fulfi lling these roles and tasks include: receptive for feedback, proactive, non-judgmental, approachable, resilient, authoritative, assertive and charismatic. Several studies emphasized the importance of voluntary registration: "It is seen as an expression of motivation and enthusiasm for infection prevention and control, which are perceived as core competences for the uptake of the ICLN role. Authority is perceived as essential for carrying out the role, therefore clinically experienced nurses are preferred as ICLN. The Royal College of Nursing summarized competences of ICLN as 'to be passionate about infection prevention and control, responsible for own actions, an active participant in the ICLN network, approachable, non-judgmental, inclusive, refl ective, and respectful.'" Regarding the implementation of ICLN programs, the researchers identifi ed operational barriers, including several papers that reported on ICLN programs that discontinued due to operational diffi culties. The researchers also found that "ICLN struggle with low staffi ng and high workload leaving insuffi cient time for ICLN activities. High staff turnover challenges hospitals to keep the number of trained ICLN up to standard." Interestingly, the researchers found a few papers describing the presence of ICLN as a risk: "Although visibility of ICLN in their role is perceived essential to trigger behavioral change, other healthcare workers may foster the idea that infection prevention and control is not their concern and rely on the ICLN for all infection prevention and control matters. None of the studies provided clues or insights in what aspects of ICLN programs were most effective." Dekker, et al. (2019) note, "Although the quantity and quality of research on ICLN is limited, a common theme that emerges is that a number of factors are considered vital for the support of ICLN in the completion of their tasks. First, educational programs are important. This is in line with previous fi ndings that show that, to improve infection prevention practices education of healthcare workers is vital. The content and delivery of education in ICLN programs is not standardized, but in general, education of ICLN by the infection prevention and control team to educate on infection prevention topics in regular meetings is considered best practice. This education can be extended by training in implementation skills by experts. With respect to how to set up educational meetings, focusing on one topic at each meeting is seen as important. The ICLN profi le is fl exible and must be tailored to the local needs. This is essential to facilitate nurses in the ownership of the ICLN role. A role profi le clarifi es expectations of ICLN for all stakeholders. It facilitates communication on the ICLN role and tasks within the organization. Support by the management at ward level can empower ICLN to act as a role model and to disseminate knowledge to their peers. The adherence to guidelines will improve when management supports infection prevention and control measures since this improves their leadership." Until next month, bust those bugs! Reference: Dekker M, et al. Infection control link nurses in acute care hospitals: a scoping review. Antimicrobial Resistance & Infection Control. 2019;8:20.

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