Become and maintain training as an IP
- Complete Initial IP Training by completing one of the three CDPH-approved programs:
- CDC Nursing Home Infection Preventionist Training Courseis a free, 19-hour online course. For more information see CDC Infection Prevention Training Guidance for LTCFs.
- CDPH HAI Program Infection Preventionist Training Course for Skilled Nursing Facilities is a free, 14-hour course.
- The Association for Professionals in Infection Control and Epidemiology (APIC) offers several online courses with varying prices and completion times.
- Annually, an additional 10 hours of continuing education in the field of IPC is required as stated in CDPH AFL 20-84. CDPH allows the IP to repeat the initial course in following years to meet the IP CE annual requirement. However, check with the Board of Registered Nursing (BRN) as they may not allow an identical course to be repeated for BRN CE during the same licensure period.
Steps to build your IP Program
1. Essential Components of your IPP
Use an IP Orientation Checklist to standardize essential components of an IP program and ensure consistency: IP Orientation Checklist
2. Assess the strengths and areas for improvement
3. Risk Assessment
Use the Infection Prevention Post-Acute Risk Assessment Prioritization Worksheet to help your facility prioritize and determine where to start focusing your IP efforts.
4. Develop an Action Plan
Areas of concern identified through your risk assessment in Step 3 will allow you to next work to:
- Identify strategies and best practices to be put into place
- Determine who is responsible for that work
- Establish a timeline for completion
- Evaluate effectiveness of those efforts through surveillance
- Gather feedback from frontline staff (RN, LVN, CNA), DON/ADON, DSD, Admin, Providers on your plan
See Example Modifiable Action Plan Templates: Generic 1-page templates | COVID-19 template
5. Implement your action plan
Keys to successfully implementing your action plan include:
- Educating all stakeholders, including facility leadership, regarding expectations
- Empowering staff to speak up
- Engaging staff members, providers, and residents in the process
- Modifying your action plan as necessary.
6. Measures to Evaluate Your Plan
Evaluate your plan by conducting surveillance: This allows your facility to analyze key data to determine effectiveness. There are two key components of surveillance: process measures and outcome measures.
Process measures
Process measures are important in quality improvement as they describe whether or not a strategy or intervention has been ‘properly performed’ or if we are ‘doing the things we say we should do’. From an improvement perspective, they make the important connection between behavioral changes and outcomes.
Examples of process measures include the following adherence Monitoring Tools:
CDPH Tools
- Hand Hygiene
- Contact Precautions
- Environmental Cleaning & Disinfection
- Fluorescent Marker Assessment Tool
Outcome measures
Examples of outcome measures are the data that gets reported and reflect the impact or end result of the health care service, strategy, or intervention on the health status of patients. While outcome measures may be seen as a key method of measuring quality, an outcome is truly the result of numerous factors, many of which may be beyond providers’ control.
Resources include:
Revised McGeer Criteria checklists
- Maryland Dept. of Health UTI Surveillance Checklist
- McGeer Criteria for Infection Surveillance Checklist Template
