By Luz Caicedo, MPH, CPH, CIC and Danielle Walden, MPH, Florida Department of Health in Orange County

In 2018, the Florida Department of Health (Department), Health Care-Associated Infections (HAI) Infection Prevention Program, in collaboration with the Florida Department of Health in Orange County (DOH-Orange), established the HAI Certification in Infection Prevention and Control (CIC) Study Group.

The Centers for Disease Control and Prevention (CDC) recently reported that in 2011 there were an estimated 722,000 HAIs in U.S. acute-care hospitals. Approximately 75,000 of those patients with HAIs died during hospitalization. Public health surveillance, prevention and response are key to reducing the number of HAIs in local communities. Currently, health department involvement in HAI prevention is primarily through surveillance of reportable diseases and conditions as well as HAI outbreak response. According to CDC, outbreaks in health care settings are often attributed to failures in infection control practices or contaminated equipment or medications. It is important for public health staff to be knowledgeable in infection prevention and control. One of the key challenges for HAI prevention and response for public health staff is access to education and training on infection control. Based on a recent survey, 10 out of 104 (9.6%) epidemiology public health staff members in the Department hold the CIC credential. This low prevalence illustrates the need to implement a strategy to increase education and training in infection control for public health staff.

To understand how Florida could improve their capacity in HAI outbreak prevention and response, the HAI Infection Prevention Program, in collaboration with DOH-Orange conducted the survey, “Certification in Infection Prevention and Control Employee Assessment,” in November 2017. Over 75% of epidemiologists and nurse epidemiologists stated that they were interested in obtaining the CIC credential. The CIC credential can be achieved by passing an examination administered by the Certification Board in Infection Control and Epidemiology, Inc. (CBIC). CBIC states that “the purpose of the certification process is to protect the public by providing standardized measurement of current basic knowledge needed for persons practicing infection control.” Since 2015, the National Association of County and City Health Officials (NACCHO) has been supporting DOH-Orange by providing funding for staff to obtain study materials for the CIC examination. Since 2015, seven epidemiologists in Orange County have passed their CIC examination.

To continue this initiative, the HAI Infection Prevention Program made it their goal to improve infection prevention and control competency by increasing the number of CIC-credentialed staff at county health departments (CHDs). Since most respondents reported that they would prefer educational webinars focused on infection control topics and online text access to infection control subject matter to prepare for the exam, the Department formed the HAI CIC Study Group.

The HAI CIC Study Group was founded on January 22, 2018, and is led by Luz Caicedo, MPH, CPH, CIC, an epidemiologist assigned by the HAI Infection Prevention Program to DOH-Orange. The group meets weekly via webinars to cover selected chapters from the Association for Professionals in Infection Control and Epidemiology (APIC) “Text of Infection Control and Epidemiology, 4th edition.” The webinars are designed as interactive audio-visual lectures, case studies, group discussions, and peer learning. The pilot group has 13 members from Miami-Dade County (1), Orange County (9), Seminole County (2) and the HAI Infection Prevention Program (1). All group members have access to the APIC Text of Infection Control and Epidemiology 4th edition, and the Certification Study Guide 6th edition. A post-survey will be conducted after the group concludes to assess the benefits and shortcomings of the group. Additionally, the “CIC Assessment Employee Survey” will be distributed in November 2018 to assess any changes from the previous survey.

Although the project has not ended, Florida has gained one new CIC-credentialed public health staff member. Currently, two other group members have registered to take the exam within the next 90 days. Some of the barriers that we experienced were technical difficulties, group engagement during each session, and decreased group participation throughout the entirety of the study group. To enhance the learning experience, we moved our group meetings from Skype to GoToWebinar. GoToWebinar allowed for staff to participate anonymously, and allowed us to record the sessions. To increase group engagement, we encouraged group members to develop presentations on varying chapters from the APIC text. For our next cohort, we will require potential group members to submit an application. In the application, they must indicate how obtaining the CIC credential will benefit their work. With this application process, we hope to recruit and retain public health staff in need of resources, education, and training specific to infection control.

With the continuation of the Department’s HAI CIC Study Group, the HAI Infection Prevention Program will continue to support staff to become certified, thereby improving Florida’s capacity to respond to HAI outbreaks. Educating public health staff in infection prevention and control will provide a more equal level of collaboration between healthcare facilities and public health. Interested persons please contact Luz Caicedo at [email protected].