Welcome to Taking Healthcare by Storm, Industry Insights, the podcast that delves into the captivating intersection of innovation, science, compassion and care.
In each episode, Quality Insights Medical Director, Dr.
Jean Storm, will have the privilege of engaging with leading experts across diverse fields, including dieticians, pharmacists and brave patients navigating their own healthcare journeys.
Our mission is to bring you the best healthcare insights, drawing from the expertise of professionals across West Virginia, Pennsylvania and the nation.
Subscribe now and together we can take healthcare by storm.
Hello everyone and welcome to Taking Healthcare by Storm.
I am Dr.
Jean Storm and I am the Medical Director at Quality Insights and today we are going to be talking to two guests about something that is so very important in our post pandemic.
I say post pandemic, but we all know COVID is still out there, but we have so many other infectious agents kind of lurking in the healthcare environment that we really need some infection control, infection prevention warriors with us.
So we have two individuals with us today that I'm not gonna say hero, I'm gonna call them sheroes because they are certainly fall into that category because they're both fighting the good fight against all things infection prevention and infection control in the healthcare environment.
We're primarily gonna be talking about nursing homes today.
And we're gonna be talking about a specialized training that I love and I was lucky enough to witness in person and that is the Infection Preventionist Boot Camp.
So today we are being joined by Gina Yekenchik, who is an infection preventionist.
She's an RN BSN and she is working in the field in long-term care.
And we are also being joined by Jennifer Brown, BSN RN CIC as she has her certification in infection control.
And Jennifer is the developer and the teacher of the Infection Preventionist Boot Camp.
So that's what we are going to be talking about today.
Thank you both for joining us.
Hi, thank you.
All right, Gina, we're going to jump right in.
Tell us how you came to do what you do.
Well, I've been a nurse about 35 years.
I started out in acute care.
I worked in an ambulatory surgery recovery room area for about 20 years, but the hospital that I worked at closed.
So I had to find a new path.
And I happened to, there was a staff development position at a nursing home in my area.
So I applied for that and I started out.
That's how I got into long-term care.
And then I moved from staff development to be an ARNAC.
And I got to meet Deborah Wright, and she hired me as the ARNAC at her facility.
And that's how I came to be where I am today.
And then the facility that I currently work at, the infection preventionist had resigned.
And I just took over that position as well.
I see.
So, I mean, that's the most, I will say, I feel it's the most important job in the facility.
So obviously you're an important, knowledgeable individual to come into that role.
I hope, thank you.
So can you tell us what the day in the life of an infection preventionist looks like?
Yes, it's very busy.
Usually, I do have a helper.
Usually we begin, we review the 24-hour summary and the order recaps to see, you know, if there's any potential infections, anyone that started on new antibiotics.
We update our line listing.
We keep a list of all of the residents that have any type of infections, any type of antibiotics.
And then we move on to looking if anyone had urine cultures and started on antibiotics, we wanna make sure that they have the appropriate antibiotics.
So we review the sensitivity.
We do infection control rounds where we go through the whole facility and make sure that everything looks okay.
And the staff are doing what they're supposed to be doing as far as preventing infections, good hand washing, disinfecting, things like that.
And we watch all staff, not just nursing, we watch housekeeping, maintenance, dietary, just to make sure we're preventing as much as we can.
Yeah, and I think people really aren't aware of how much is going on behind the scenes to really monitor all infections in the facility, all antibiotic use.
We know infections are a problem.
We should also know that antibiotic resistance is a problem.
So, I mean, there's so much going on in a day-to-day basis.
What do you find is the most challenging part of your job as an infection preventionist?
It's a difficult question.
It's difficult to find the most challenging.
There's quite a few challenging things.
Probably making sure we are not using unnecessary antibiotics, that could be difficult.
We sometimes have a little bit of pressure from the families to initiate antibiotics, especially if residents are having maybe a change in mentation.
Families want the urinalysis done right away with the culture and often they pressure the physicians to start the antibiotic even before we have any of the results back.
The other challenge we also have is documentation to support the start of antibiotics or the need for, even the need for the urine cultures.
Sometimes there's not enough documentation to support the criteria that we should even be doing any kind of testing.
So we have to go out and talk with the staff, make sure that they know what to document, they know what to be looking for.
So that's a bit of a challenge.
Yeah, and I think that people really don't understand the harm that can come by just even doing a test.
People think, oh, we'll just order the test.
That's fine.
But the issue is then you have to do something with the result, and it may not be due to an infection.
Well, yes.
Yeah, it's very, very challenging.
So we have to talk about COVID a little bit.
Is COVID still a challenge and an issue in your facility?
Currently, it hasn't been.
We haven't had any cases probably since January.
I did hear, though, there are some cases popping up in the community.
So right now, it's not a challenge.
But one of the issues we're going to be having, we had been all private rooms, but recently we have added some double rooms.
So that's gonna be a challenge when it comes around again, because we hadn't really had to move people or figure out where to put anyone.
But now I think that's going to be an issue.
Yes, yes.
But I'm sure you're going to be on top of it.
We have a good facility.
Everybody works together, so we do well.
That's great.
Yes, team is very important.
So we're gonna talk a little bit about enhanced barrier precautions.
So I've actually done some education around enhanced barrier precautions.
And I know Jen has as well for Quality Insights.
And I will say I have gotten a lot of very, very challenging questions, not only during our webinars, but also sent to me via email, just very challenging questions around enhanced barrier precautions.
And so these are precautions that are implemented if an individual has an indwelling medical device or has a wound or has an MDRO that is targeted by the CDC.
And we have a lot of information, if anybody would like to read more, that's just a short summary.
But Gina, has it been a challenge to implement enhanced barrier precautions in your facility?
It has.
We don't have that many residents that require them right now, but it is, it was a challenge having the staff understand, and all of the staff, again, not just nursing, but all of the staff understand what they're all about and who needs them and when they need to wear their PPE.
So we did have quite a few questions.
I think we're doing okay right now.
We do still have, we have some agency staff that come in and that is, I think, our biggest challenge at the moment is making the agency staff aware and having them follow the precautions.
Yeah, I can imagine that keeping the education, you know, consistent when you have new staff coming in.
Are you seeing a lot of, a large amount of resistant organisms in the facility?
We do not have a large amount, no, thankfully.
I think we have 65 residents right now, and I think we have five that have had something in the past, mostly ESBL and MRSA.
That's fantastic.
I mean, that shows that what you're doing is working because, you know, typically we know if you have a resistant organism in the facility, it spreads typically through staff, through care of the resident.
So that's fantastic.
You guys are doing a wonderful job then of keeping the spread down.
We have great staff.
They really do a good job.
Good.
So Jen, I talked a little bit about this infection prevention as a bootcamp.
Can you kind of give us an overview of the IP bootcamp?
Yes, so the infection prevention is leadership bootcamp is a two-day educational conference that was rolled out in West Virginia to nursing home infection preventionists.
This program was designed to provide some additional infection prevention education on top of what they already learned through their certification program and also leadership development to help attendees feel more confident in their role as the IP.
So as the name implies, there was a lot of education provided up front during the first, those two days that we had together.
We covered everything from the basics of the infection preventionist role, which included information on what key duties are required for the IP.
We went over some of the infection control basics, like common infections that you see in a nursing home, regulatory requirements, how to complete the annual risk assessment, and how to conduct surveillance in nursing homes.
In addition to those things, we also went over some of the crucial aspects of the infection control program, such as antibiotic stewardship, immunization programs, occupational health, environmental infection control, and how to implement these programs into practice.
But what's just as important as the education presented at the in-person session are the follow-up sessions.
So each attendee of the in-person session was also invited to a monthly virtual follow-up session, which allows us to dive deeper into the topics that we covered and talk about some of the hot topics and emerging trends in infection control, and also provides opportunity to share how things are going while implementing these ideas and at the facility level, and provides a little time for networking as well.
At networking, I feel like it's so very important.
Mm-hmm.
Yes.
So can you tell us why you feel this infection preventionist leadership boot camp is so needed?
Well, as the infection preventionist for Quality Insights, I do a lot of outreach to facilities.
I speak to a lot of infection preventionists.
Some experience, some inexperience.
But no matter the experience level, there's usually only one IP in the nursing home setting.
Some are lucky enough to have a, you know, multiple or have an assistant.
But I remember when I was working in the nursing home setting, joking about my department of one.
But for IPs, especially new IPs, they might be unsure about the requirements for the role, what they need to prioritize.
And if they have questions about it, they may or may not have someone to turn to to ask about it.
So, you know, in that setting and that, you know, climate, it might cause some frustration and uncertainty, which may be one of the factors as to why the infection preventionist role can be a high turnover position, especially if there's no overlap with the previous IP.
So having this type of program available to infection preventionists is a great way to provide some foundational knowledge and also strategies to help implement certain infection control practices.
And it's also a great refresher for experienced IPs as well.
Yeah, such a fantastic opportunity with such a crucial area.
Gina, now that we kind of heard from Jen about what this boot camp actually is and what it entails, what was your initial impression of the boot camp?
Jen did a great job.
I'm relatively new as the infection preventionist, and I, like she was saying, didn't know quite where to turn sometimes.
So just knowing that there's someone out there, you know, to support questions if I have, or also, I guess, also seeing other or talking with other infection preventionists and knowing that I'm not the only one having the issues that I'm having.
The other thing that was very beneficial, Jen had different scenarios, and she would break us off into groups so that we could work through the scenarios, and talking through it with other people helped, and having those, that type of opportunity just to be with other people rather than just watching a webinar was great.
And the way she introduced the information, she did a great job.
Yeah, I would agree.
Sharing what everyone is doing, I think, is so very important, especially in this area.
So, Gina, what did you find was the most important takeaway from the boot camp?
Just how important infection control is in a long-term care facility.
Everybody knows it's important, and how it encompasses every department.
Just...
I'm not even sure how to say it, but it's so important.
And having the support for the IEP is very...
I'm very grateful for knowing that there's support out there, and knowing that there are other people going through the same thing, and that I have somewhere to turn when I don't know what to do.
Yeah, I think it may be taught to you all that you're the most important people in the facility.
I think that's it.
It's an important message.
So, Gina, I guess just last question for you, and I'm going to ask the same question of Jen.
Do you think that every infection preventionist should attend in training like the boot camp?
Definitely, yes.
Yeah, super important.
Jen, what about you?
Do you think every infection preventionist should attend the training?
Yes, I agree with Gina.
Infection prevention, like you said, is the heart of nursing homes.
It affects every department, and everyone has a role in it.
So having a program like the Infection Preventionist Leadership Weekend provides education, but also information about how to implement those programs.
Also provides support from subject matter experts and also those network opportunities that we talked about.
And it allows IPs to get the support they need.
That way, they don't feel like they have to go it alone.
There is support out there.
There's resources, and that's one of the things I try to share, different links, different resources to help IPs get the information that they need.
And this program also provides leadership skills required for the IP role, so that IPs feel comfortable in their workflow.
And also how to work effectively with other members of the multidisciplinary team and make confident decisions to strengthen their infection control programs.
Yeah, that leadership role is so, so very important.
Well, thank you both so very much.
If individuals have any questions about getting some information on the bootcamp, Jen, can they just reach out to the Quality Insights website?
Yes, the Quality Insights website, or you can email me, jbrown, at qualityinsights.org.
Wonderful.
Well, thank you so very much for joining us.
Thank you.
Thank you for tuning in to Taking Healthcare by Storm, Industry Insights, with Quality Insights Medical Director Dr.
Jean Storm.
We hope that you enjoyed this episode.
If you found value in what you heard, please consider subscribing to our podcast on your favorite platform.
If you have any topics or guests you'd like to see on future episodes, you can reach out to us on our website.
We would love to hear from you.
So until next time, stay curious, stay compassionate, and keep taking healthcare by storm.
