Advertisement

Infection control standards and credentialing

Published:August 25, 2015DOI:https://doi.org/10.1016/j.ajic.2015.06.034
      To the Editor:
      Infection control professionals (ICPs) play an integral part of developing, implementing, and evaluating infection control programs. In Australia, there is no minimum or standardized education to practice as an ICP. The Australasian College of Infection Prevention and Control, the professional body for ICPs in Australasia, sought to address the issue by developing a credentialing process.
      • Gardner G.
      • Macbeth D.
      Credentialling the infection control practitioner - draft proposal.
      • Olesen D.
      Credentialling proposal: a report on responses to questions.
      • Macbeth D.
      Pathway to credentials.
      This decision was made in recognition that self-regulation is one of the hallmarks of professionalism.
      Coalition of National Nursing Organisations
      National nurse credentialing framework.
      The process of becoming credentialed as an ICP in Australia involves the submission of evidence against a range of criteria with a subsequent peer-review process.

      Australasian College of Infection Prevention and Control. Credentialled Infection Control Professional (CICP) Application Package: 2014. Available from: http://www.acipc.org.au/Credentialling/What-is-Credentialling. Accessed June 9, 2015.

      Despite the longstanding nature of the ICP credentialing process, only a small number of Australasian College of Infection Prevention and Control members are credentialed, a fact we have explored in recent publications.
      • Hall L.
      • Halton K.
      • MacBeth D.
      • Gardner A.
      • Mitchell B.G.
      Roles, responsibilities and scope of practice: describing the state of play for infection control professionals in Australia and New Zealand.
      • Mitchell B.G.
      • Hall L.
      • MacBeth D.
      • Gardner A.
      • Halton K.
      Hospital infection control units: staffing, costs, and priorities.
      As part of a larger research program, we undertook a cross-sectional study of lead ICPs in Australian hospital infection control units.
      • Mitchell B.G.
      • Hall L.
      • MacBeth D.
      • Gardner A.
      • Halton K.
      Hospital infection control units: staffing, costs, and priorities.
      The study involved inviting hospital infection control units to participate in a confidential Web-based survey. Full details regarding the methods have been published in an earlier issue of this journal.
      • Mitchell B.G.
      • Hall L.
      • MacBeth D.
      • Gardner A.
      • Halton K.
      Hospital infection control units: staffing, costs, and priorities.
      In brief, participants were asked demographic information about their hospital; current staffing level, grades, and contract hours; details about information technology systems used to support practice; and hours spent undertaking various infection control activities. Participants were also asked to provide details on specific infection control–related outputs and patient outcomes in the previous 12 months, including results from their most recent accreditation process.
      Since publication, we have sought to explore the relationships between infection control units that were led by a credentialed ICP and results from an external infection prevention and control accreditation process. The purpose of this letter is to describe the relationship we identified between hospital accreditation outcomes and credentialing.
      In Australia, hospitals are required to be assessed against infection prevention and control accreditation standards by external accreditation organizations.
      Australian Commission on Safety and Quality in Health Care
      National safety and quality health service standards.
      There are predominantly 2 accreditation agencies in Australia, and each has different accreditation outcomes: passed and extensive achievement for one agency and achieved and met with merit for the other. To assess the relationship between credentialing and accreditation outcomes, we defined the accreditation outcome into dichotomous variables: passed (which included achieved) and met with merit (which included extensive achievement). These dichotomous variables were compared against whether the infection control unit was led by a credentialed ICP (yes or no) using Pearson χ2 test.
      Surveys from 49 individual infection control units were completed, accounting for 152 Australian hospitals. The mean number of ICPs in the Australian hospitals surveyed (49 infection control units covering 152 hospitals) was 0.66 per 100 overnight beds (95% confidence interval, 0.55-0.77), with units led by a credentialed ICP having 0.80 (95% confidence interval, 0.77-0.83) ICPs per 100 beds.
      • Mitchell B.G.
      • Hall L.
      • MacBeth D.
      • Gardner A.
      • Halton K.
      Hospital infection control units: staffing, costs, and priorities.
      There was a significant association between infection control programs led by a credentialed and an accreditation outcome met with merit (r = 0.38, P = .026) (Table 1).
      Table 1Accreditation outcome
      Infection control unitAccreditation outcomeTotal
      PassMet with merit
      Led by credentialed ICP
       No19423
       Yes5611
      Total241034
      NOTE. Pass also includes the met category. Met with merit also includes the extensive achievement category.
      ICP, infection control professional.
      Met with merit means that measures are above the minimum requirements for accreditation and may result from the ability to take novel approaches to problems and issues caused by staffing and resource advantages. Although the results of this study suggest that credentialing was associated with a better accreditation outcome, it can only explain 14.4% of the variation. This study is the first to report on accreditation outcomes and a relationship with credentialing. The generalizability is hampered by the relatively small sample size. None the less, we believe our findings justify the need for further research in this area. It would be possible to explore existing, much larger accreditation outcome databases and link these to hospital and infection control unit characteristics.

      References

        • Gardner G.
        • Macbeth D.
        Credentialling the infection control practitioner - draft proposal.
        Healthc Infect. 1997; 2: 19-20
        • Olesen D.
        Credentialling proposal: a report on responses to questions.
        Healthc Infect. 1998; 3: 23-24
        • Macbeth D.
        Pathway to credentials.
        Healthc Infect. 1999; 4: 21-23
        • Coalition of National Nursing Organisations
        National nurse credentialing framework.
        Coalition of National Nursing Organisations, Canberra, Australia2011
      1. Australasian College of Infection Prevention and Control. Credentialled Infection Control Professional (CICP) Application Package: 2014. Available from: http://www.acipc.org.au/Credentialling/What-is-Credentialling. Accessed June 9, 2015.

        • Hall L.
        • Halton K.
        • MacBeth D.
        • Gardner A.
        • Mitchell B.G.
        Roles, responsibilities and scope of practice: describing the state of play for infection control professionals in Australia and New Zealand.
        Healthc Infect. 2015; 20: 29-35
        • Mitchell B.G.
        • Hall L.
        • MacBeth D.
        • Gardner A.
        • Halton K.
        Hospital infection control units: staffing, costs, and priorities.
        Am J Infect Control. 2015; 43: 612-616
        • Australian Commission on Safety and Quality in Health Care
        National safety and quality health service standards.
        Australian Commission on Safety and Quality in Health Care, Sydney (Australia)2011