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Appendix
Appendix
2018-2022 LEAP Experiential Curriculum
Hospital epidemiology
• Experiences
• Core
• Core infection prevention/hospital epidemiology program work meeting –Participate in the regular workgroup meeting for the infection prevention/hospital epidemiology program at your hospital. Key learning points include how HAIs are monitored in the hospital, how the efficacy of interventions is monitored, how HAI concerns and leadership are addressed by the infection prevention program, and what day-to-day activities infection preventionists and hospital epidemiologists engage in.
• Tracking metrics – Numerator/denominator.• HAI review – Engage with whomever performs HAI review and the HAI review process (identifying if they meet NHSN definitions) and adjudication meetings. Learn surveillance definitions for HAIs and how they differ from clinical criteria.• HAI cluster/outbreak workup – Participate in at least one HAI cluster workup. Learning points include how to create a proper case criterion and retrospectively identifying potential cases, what kind of data are needed to create a case detail listing (line list), how to appropriately select controls and how to create an epidemic curve. Learn how to utilize exposure ratios, relative risk, and odds rations and confidence intervals in appropriately selecting cases and controls. Learn how to approach multidisciplinary case workup and interventions.• Surgical observation – Participate in at least one surgical procedure observation. Learn about the types of potential surgical infection risks, the interventions used to minimize them and the types of monitoring used to maintain control over SSIs.• Environment of care rounding – Participate in at least one EoC assessment. Learn what types of environmental hazards are examined by infection prevention and which hospital departments are in charge of maintaining a safe environment for patients.• Infection control risk assessment – Participate in an ICRA and learn how infection preventionists assess a location’s infection risk and how that influences the types of infection control measures needed for that area.• Infection preventionist shadowing – Shadow infection preventionists at least once. Learn what their normal activities entail, what types of surveillance they perform and how they act in the hospital to minimize the acquisition and spread of HAIs.
• Supplemental
• Joint epi/central sterile meetings – If any discussions are being had between central sterile (i.e., sterile reprocessing) and hospital epidemiology/infection control, the fellow should participate to learn what types of device and equipment reprocessing issues are relevant to infection control. Particular learning points include how the different levels of processing (sterilization, high-level disinfection, low-level disinfection, nonsterile cleaning) change the needed processing techniques and handling/storage issues.
• Joint epi/micro meetings – Participate in any discussions being held between the microbiology lab and hospital epidemiology/infection control. Learn how microbiology interfaces with infection control, how microbial screening is utilized to reduce rates of HAI acquisition and colonization, and how advanced diagnostic techniques are being utilized and addressed by infection control and hospital epidemiology. Also learn how yearly antibiograms are created and disseminated to hospital staff.
• Joint epi/environmental services meetings – Participate in any discussions being held between EVS and hospital epidemiology/infection control to learn what types of monitoring by infection control are used to maintain proper standards of environmental hygiene, and what additional interventions are used by EVS to protect specialized populations and reduce incidence of infection such as CDI.
• Supporting literature• Infection control policy reviews.
• Lautenbach, Ebbing, Keith F. Woeltje, and Preeti N. Malani. Practical Healthcare Epidemiology. Chicago: Published for the Society for Healthcare Epidemiology of America by the University of Chicago Press, 2010 (particularly Chapter 8).