Leading Infection Prevention for Health Care Workers

This page summarizes section 1, Leadership and Management, of CDC's guideline Infection Control in Healthcare Personnel (Part I: Infrastructure and Routine Practices). It covers how health care organizations should lead and manage occupational infection prevention and control (IPC) — the services that protect health care personnel from infections at work. Section 2, Communication and Collaboration, has related recommendations.

For organization leaders and administrators

• 1.a. Invest in a culture that puts safety and occupational infection prevention first.
• 1.b. Review information on workers' infection risks, exposures and illnesses regularly with occupational health services (OHS).
• 1.c. Put one or more trained people with real authority in charge of occupational IPC.
• 1.d. Provide enough expertise, money, staff, supplies and information technology to carry out all the elements of occupational IPC:
• • leadership and management;
  • communication and collaboration;
  • assessing and reducing infection risks among personnel;
  • medical evaluations;
  • education and training;
  • immunization programs;
  • managing potentially infectious exposures and illnesses;
  • managing personnel health records.
• 1.e. Oversee performance measurement and continuous quality improvement for these services, and include OHS leaders in it.

For occupational health services leaders and staff

• 1.f. Promote a culture with a steady focus on safety and occupational IPC.
• 1.g. Tailor services to workers' needs and their work environment.
• 1.h. Write, review and update policies and procedures for each element above, in line with federal, state and local requirements.
• 1.i. Tell all personnel and relevant departments about these policies.
• 1.j. Work with the right departments and people to:
• 1. comply with regulations on occupational IPC;
  2. plan for infectious disease emergencies and outbreaks;
  3. track performance measures, including the share of personnel with documented immunity to, and vaccination against, each vaccine-preventable disease the Advisory Committee on Immunization Practices recommends for health care personnel;
  4. set and meet quality improvement goals and report results and gaps to management;
  5. periodically assess how well the services work.

Why leadership matters

OHS leaders oversee occupational IPC services and monitor their quality, sharing planning with human resources, facility IPC, facilities management and environmental services. Support from the organization's leadership is critical to that collaboration. Leaders improve services by writing routine and emergency policies, being accountable for quality, pursuing continuous improvement, and working with other IPC programs.

Good occupational IPC services can:

• improve workers' health, job satisfaction and morale;
• support a culture of safety;
• prevent infections in workers and protect the patients, co-workers and families they interact with;
• save money.

How services are organized varies with an organization's structure, facilities, clinical work and staff. Certifications in occupational medicine and occupational health nursing are available — for example from the American Board of Preventive Medicine and the American Board for Occupational Health Nurses — and organizations can add their own IPC training.

Meeting requirements

OHS leaders may be responsible for following clinical guidelines and legal requirements, such as the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens standard (including annual updates of exposure control plans and exposure management for employees) and its Personal Protective Equipment standard (including training and demonstrated competency). They can also support accreditation and reimbursement goals: The Joint Commission requires goals for raising influenza vaccination among personnel and standards to prevent infection spreading among patients, practitioners and staff, and the Centers for Medicare & Medicaid Services' Conditions of Participation require hospitals to identify and track certain communicable diseases among personnel.

Measuring performance

Performance measures show where services fall short, point to improvements and track progress over time; regulators, accreditors and payers may require them, such as CMS's requirement to report personnel influenza vaccination. Examples:

Emergencies and outbreaks

Emerging pathogens are infecting health care personnel more often — pandemic influenza, Middle East Respiratory Syndrome coronavirus and Ebola among them — so OHS should take part in emergency planning. Caring for such patients can require training in new PPE, monitoring workers' health and safety, and post-exposure care; outbreaks involving staff can require contact tracing and screening.

Sources

• Centers for Disease Control and Prevention: Infection Control in Healthcare Personnel, Part I, "1. Leadership and Management."