Denise C. Murphy

Challenges associated with assessment of risk for tuberculosis in a dental school setting

BACKGROUND Reported risk among health care workers, related to tuberculosis exposure, motivated us to accurately assess this occupational risk at our College of Dentistry. METHODS Our sample population included all dental students entering their junior (third) year (beginning of maximum patient exposure). Screening for tuberculosis infection, with the standardized Mantoux test (purified protein derivative [PPD]), was conducted by the authors; several variables, previously associated with inaccurate test results in the literature, were controlled for during the study. RESULTS Among the study population of 158 students, the PPD conversion rate, as determined by one-step testing, after one academic year was 10.6%. To further investigate factors (other than possible workplace exposure) contributing to PPD conversion in the study population, the authors also examined PPD results from previous employee and student screenings and conducted a retrospective chart review of selected patients registered at the college for the same period. CONCLUSIONS We found that being born outside of the United States and having previously received bacille Calmette-Guérin vaccine are associated with positive PPD test results. In addition, PPD conversion among the study group may not be associated with occupational exposure at the College but, in fact, may be related to other factors, including community- and hospital-based clinical exposure. Finally, we recommend further research that examines the possible systemic effects of periodic testing with PPD on test subjects.

Creation of a competency-based professional development program for infection preventionists guided by the APIC Competency Model: steps in the process

Background: Infection Preventionists have varying levels of educational preparation. Many have no prior experience in IP. The diversity makes design of professional development programs challenging. Recent surveys suggest that only about half of practicing IPs are board certified. There is an urgent need to employ competent IPs to drive improvement in patient outcomes. Methods: This is a project that utilized the APIC Competency Model to create a professional development program characterizing three career stages. Methods included a review of literature on professional development; a survey of IP competence; an assessment of job descriptions and performance evaluations; and a crosswalk of IP competencies. Results: The professional development program includes competency ‐ based IP job descriptions and performance evaluations for each career stage; a professional portfolio; and a toolkit for supervisors. Discussion: Participants agreed that application of the model resulted in tools which are more closely aligned with current roles for IPs; and increased satisfaction and motivation with the new program. Conclusion: Competent and knowledgeable IPs are crucial to optimizing efficacy of IPC programs. A professional development program has the potential to guide staff orientation, improve satisfaction and retention, improve patient outcomes and promote a positive trajectory in advancing practice.

Frequency of Outbreak Investigations in US Hospitals

Methods: A 2-part survey was developed and sent via email to APICmembers in US hospitals in early 2010. Part 1 of the survey involved information on hospital demographics and the infection prevention/control program; Part 2 included questions about specific outbreak investigations including unit/department closures. The survey could accommodate information for up to 8 outbreak investigations and specified activities within the previous 24 months.