infection prevention
infection prevention
By Linda Goss , DNP , BS , APRN , ANP-BC , COHN-S , CIC , FAPIC
Facility Risk Assessment in Infection Control : Do We Need a Standard ?
The results of the risk assessment should be used to guide surveillance and prevention activities as well as to develop goals . The emphasis on this process for prioritizing the next fiscal year activities would seemingly be better served with a more rigorous design .”
Assessing risk in infection control is second nature ; determining which format and numerical rating system to use is not always as clear . A quick search of the Centers for Disease Control and Prevention ( CDC ) website will reveal guidance and / or templates for assessing risk in occupational health and safety , water safety , tuberculosis and more .
While the goal is clear — risk should be assessed — the process contains gaps and variability . A similar challenge is discussed in a publication titled Risk Analysis in Healthcare Organizations : Methodological Framework and Critical Variables , where the authors describe concerns in the approach to risk assessment in the field of risk management in healthcare . As discussed in the paper , risk management professionals are tasked with determining risk using a high low format however as the authors note they too could benefit from definitions and perhaps a revised or totally new design .
The infection preventionist ( IP ) designs the infection prevention and control program based on the results of the facility risk assessment which includes the following :
● Geographic location and the community and population served by the facility
● The various care , services and treatment provided at the facility
● Local , state and / or federal requirements
The results of the risk assessment should be used to guide surveillance and prevention activities as well as to develop goals . The emphasis on this process for prioritizing the next fiscal year activities would seemingly be better served with a more rigorous design . The infection prevention team generally decides what numerical rating system to use including 1-5 , or 1-10 or even a 1-65 . Additionally , the decision to total the numbers after they have been assigned to a risk category or multiply them is also left up to preference . While the rating implies a quantitative analysis it is typically developed in a qualitative manner due mainly to the subjectivity in the scoring process . How reliable is the prioritization of infection control activities when the scale variability is so evident .
Reducing variability may be achieved by aligning with the International Organization for Standardization ( ISO ). ISO is a non-governmental agency that relies on the expertise of members from around the world to develop and provide consensus on standards for management , technology and manufacturing . The standards provide structure and rigor , and stakeholders are explicitly challenged in the process of standard development to play a role in the outcome . Globally , organizations rely on ISO standards to do business as they know there is a high degree of reliability in the standard development process . One example , ISO 35001.2019 . provides standards for a biorisk management system . The associated document provides the user with a familiar format ; plan , do , check and act .
Furthermore , ISO membership consists of a network of standards bodies from around the world . The United States representation comes from the American Standards National Institute ( ANSI ). ANSI coordinates the voluntary consensus standards in the United States . It doesn ’ t write the standards ; rather it provides a standards framework . This discussion may seem far removed from infection control ; however , looking further into standard development will eventually lead to the American Society for Testing Materials , known as ASTM International .
Most infection preventionists are intimately familiar with ASTM and the testing standards for personal protective equipment ( PPE ), particularly masks . During the height of the COVID-19 pandemic in 2020 , ASTM opened their standards library at no cost , providing infection preventionists and others the ability to closely examine the testing requirements related to masks and other forms of PPE . When PPE was in peak demand , there were many who were attempting to discern the “ real ” from the “ fake ” and the open standards allowed for greater insight to aid in that process . ASTM took a step further and joined with the National Institute for Occupational Safety and Health Administration ( NIOSH ) to develop F3502.21 , a new standard addressing barrier face coverings .
More information on this standard can be found here .
These standards are applicable to and followed by infection control as they directly impact healthcare workers and patients along with those from the Occupational Health and Safety Administration ( OSHA ) and the Association for the Advancement of Medical Instrumentation ( AAMI ). However , once more when it is time to review and / or develop the risk assessment that will guide the program into the future there is a lack of standardization . This is evidenced by the decision by some to document the findings in a standard 8 ½ x 11-inch format to
10 • www . healthcarehygienemagazine . com • september 2024