By Arif Subhan, MS, CCE, FACCE CCE-Prep-Arif-Subhan

This article is a continuation of the previous article on Committee Management, which appeared in the November 2012 issue of 24×7’s “CCE Prep” column and discussed the hospital Patient Safety Committee. This article will review the hospital’s Infection Control (IC) Committee.

According to the Centers for Disease Control and Prevention (CDC), health care-associated infections (HAI) in hospitals are a significant cause of morbidity and mortality in the United States. The CDC estimated that 1.7 million HAIs occurred in US hospitals in 2002 and were associated with approximately 99,000 deaths. The CDC report stated that the number of HAIs exceeded the number of cases of any currently notifiable disease (any disease that is required by law to be reported to government authorities), and deaths associated with HAIs in hospitals exceeded the number attributable to several of the top 10 leading causes of death reported in US vital statistics.1

Joint Commission Standards

The Joint Commission accreditation manual has a complete chapter on infection control titled “Infection Prevention and Control (IC).” One of the standards, IC.01.01.01, requires the hospital to identify an individual responsible for the infection prevention and control program. Another standard, IC.02.02.01, requires the hospital to reduce the risk of infections associated with medical equipment, devices, and supplies. Patients are at risk of developing an infection from contact with medical equipment, devices, and supplies when getting the treatment at the hospital. If the equipment is not properly cleaned, sterilized, or disinfected, the patients could be at risk and infections may be transmitted from person to person.
IC.02.02.01 has five Elements of Performance (EPs), with requirements for cleaning; low-, intermediate-, and high-level disinfection and sterilization; and disposing and storing of medical equipment, devices, and supplies.2

Infection Control and Construction

The Joint Commission Environment of Care (EC) Standard EC.02.06.05 states that the hospital must manage its environment during demolition, renovation, or new construction to reduce risk to the occupants in the organization. The three EPs in this standard require:
1) The use of the state rules/regulations or Guidelines for Design and Construction of Hospitals and Health Care Facilities (2010 edition).
2) A preconstruction risk assessment for air quality requirements, infection control, utility requirements, noise, vibration, and other hazards that affect care, treatment, and services.
3) The hospital to take action based on the assessment to reduce risks during demolition, construction, or renovation.2,4

Infection Control Risk Assessment

The Guidelines for Design and Construction of Hospitals and Health Care Facilities requires that the facility perform an infection control risk assessment, or ICRA, for construction and renovation. ICRA is a determination of the potential risk of transmission of different agents, particularly biologic, in the facility during construction.

Role of the IC Committee

Every health care facility has an Infection Control Committee that provides a forum for interdisciplinary conversation on infection control issues to minimize risk for patients and employees. The Infection Control Committee is usually comprised of members from a range of disciplines within the health care facility. Representatives include physicians, nursing, infection control, quality assurance, risk management, microbiology, surgery, central sterilization, environmental services, biomedical engineering, engineering/construction, etc. The goal of this interdisciplinary team is to bring together individuals with expertise in different areas of health care. This diverse group helps address infection control issues from several angles, and allows the members to collectively use their expertise to develop solutions addressing infection control issues.3 Biomedical/clinical engineering professionals are important members of the infection control committee due to the nature of their work with medical equipment and devices. 24×7 CCE Prep column, January 2013.

Arif Subhan, MS, CCE, FACCE, is the chief biomedical engineer at the South Texas Veterans Health Care System, San Antonio; adjunct assistant professor, biomedical engineering, University of Connecticut; and a member of 24×7’s editorial advisory board. The suggestions and views expressed in this article are of the author. They do not represent the views of the Department of Veterans Affairs or the University of Connecticut. For more information, contact [email protected].

 

Review Questions

1) In 2002, according to ____ health care-associated infections (HAI) were responsible for approximately 99,000 deaths.
a) The Joint Commission
b) The Institute of Medicine
c) The Centers for Disease Control and Prevention (CDC)
d) The American Medical Association

2) The Joint Commission accreditation manual has ____ addressing infection control.
a) A complete chapter
b) A standard
c) Two standards
d) None of the above

3) The ____ committee provides a forum for interdisciplinary conversation on infection control issues.
a) Patient Safety
b) Environment of Care
c) Life Safety
d) Infection Control

4) The ____ requires infection control risk assessment (ICRA) before starting a construction project.
a) Centers for Disease Control and Prevention (CDC)
b) American Medical Association
c) Guidelines for Design and Construction of Hospitals and Health Care Facilities
d) None of the above

5) The Joint Commission standards require preconstruction risk assessment of ____ and other hazards that affect care, treatment, and services.
a) Air quality requirements
b) Infection control
c) Noise and vibration
d) All of the above

Answers:

1-c; 2-a; 3-d; 4-c; 5-d

References
1. Estimating health care-associated infections and deaths in US hospitals, 2002 Public Health Reports. March-April 2007;122:160-166. Available at: http://www.cdc.gov/HAI/pdfs/hai/infections_deaths.pdf Accessed December 4, 2012.
2. The Joint Commission, 2012 Hospital Accreditation Standards, Oak Brook, Ill.
3. Lee F, Lind N. The Infection Control Committee. Infection Control Today. June 1, 2000. Available at: http://www.infectioncontroltoday.com/articles/2000/06/the-infection-control-committee.aspx Accessed December 4, 2012.
4. Weigle G. EC standards for infection control risk assessments. Health Facilities Management. Available at: http://www.hfmmagazine.com/hfmmagazine/html/WebExclusives/WebExclusives_InfectionProtection.html Accessed December 4, 2012.