APIC drafts ICP practice, professional standards

Draft version defines essential IC components

What should the practice and professional standards of today's infection control practitioner be? Amid rapid changes in health care, the Association for Professionals in Infection Control and Epidemiology (APIC) is in the process of answering that question by setting current standards for an evolving profession.

A draft of the practice and infection control standards was discussed recently in San Diego at the annual APIC conference in a session called "Defending the role of infection control professionals in the era of managed care."¹ In a joint project with the Community and Hospital Infection Control Association (CHICA-Canada), APIC has drafted standards that include the responsibilities for which ICPs are "accountable." In addition to essential practice skills, the professional standards outline a code of ethical conduct for today's ICP. (See professional standards, p. 121.)

The infection control practice standards include basic components for epidemiology, calling for the ICP to identify trends and risk factors and design prevention and control strategies. Key criteria include the development of a surveillance plan based on the patient population served, services provided, and previous surveillance data, if available. The standards call for ICPs to evaluate and compare surveillance data to either internal or external data sources and report epidemiologically significant findings to appropriate parties. The APIC practice standards also include components for education, consultation, quality improvement, program management, financial management, and research.

The practice guidelines are somewhat reflective of the essential elements of an infection control program recently recommended in a consensus panel report, which also was discussed at the same APIC session.² (See Hospital Infection Control, April 1998, pp. 51-54.)

The key difference is that the APIC practice standards are designed to apply to all settings, whereas the consensus panel report was aimed specifically at acute care hospitals, explained Paula Bullock, MED, MT, CIC, a member of the APIC standards task force and infection control coordinator at the University of Missouri Hospital and Clinics in Columbia.

"The thinking was that each program or practice setting would incorporate relevant components of the practice standards," she told APIC attendees. ". . . APIC as a professional association has a responsibility for developing generic standards that apply to the practice of all infection control professionals."

According to the draft version, the standards "define the profession's accountability to the public, including the consumer, health care worker, and the health care industry in terms of desired outcomes for which practitioners are responsible. These standards can be used to develop job descriptions and provide criteria for performance evaluations."

^{Some ICPs face certification difficulty}

The draft version was distributed at APIC for member feedback and revision before it is finalized in the coming months by the APIC and CHICA task force. One suggested revision during the discussions at APIC was that the committee reconsider the professional standard calling for ICPs to be certified in infection control within five years in the profession. That standard could be particularly difficult to meet for ICPs who are not hospital-based and may not have the resources to attend chapter meetings and educational programs, noted Sandy Pfaff, RN, an ICP at St. Joseph's Hospital in Milwaukee.

"I think the largest-growing segment of our membership are those folks who work in extended care, ambulatory care, home care, etc., and they frequently are not given the resources - financial or timewise - to attend chapter meetings [and] educational programs," she told APIC attendees. "This type of statement places them in a tenuous position with regard to being considered professionals when they in many instances will not be able to seek or achieve certification. I urge you all to seriously reconsider that particular statement."

^References

1. Association for Professionals in Infection Control and Epidemiology. APIC Professional Practice Standards Task Force. Draft: Practice and professional standards for infection control and epidemiology. APIC 25th annual conference program and handouts, pp. 267-269.

2. Scheckler WE, Brimhall D, Buck AS, et al. Requirements for infrastructure and essential activities of infection control and epidemiology in hospitals: A consensus panel report. Infect Control Hosp Epidemiol 1998; 19:114-126.