ANA/APIC Resource Center (2014-2016)

Following the Ebola crisis, the American Nurses Association (ANA) and the Association for Professionals in Infection Control and Epidemiology (APIC) recognized gaps among healthcare professionals in emergency preparedness and created a joint Working Group. These gaps are barriers in effectively decreasing health care-associated infections, which according to the Centers for Disease Control and Prevention (CDC), claim up to 75,000 lives annually.

Through the efforts of the ANA/APIC Working Group, key infection prevention areas were identified and resources consolidated to allow healthcare professionals quick and ready access to infection prevention strategies and evidence-based practices. Working Group members include:

Mary Jo Assi, DNP, RN, NEA-BC, FNP-BC
Director, Nursing Practice and Work Environment
ANA

Dorothy Belkoski BSN, RN, CCRN, CIC
Infection Preventionist
Inova Fair Oaks Hospital

Terri Bogue MSN, RN, PCNS-BC 
Chief Operating Officer, Thor Projects LLC

Katrina Crist MBA, CAE
Chief Executive Officer
APIC

Jaime Murphy Dawson, MPH
Program Director, Department of Nursing Practice and Work Environment
ANA

Elizabeth “Liz” Garman
Vice President, Communications
APIC

Miranda Grant, MPH
Infection Preventionist
Indiana University Health Methodist

Timothy Landers, PhD, RN, CNP, CIC
Assistant Professor, Ohio State University College of Nursing
Vice Chair, APIC

Elaine Larson, RN, PhD, FAAN, CIC
Anna C. Maxwell Professor of Nursing Research 
Associate Dean for Nursing Research School of Nursing
Professor of Epidemiology, Mailman School of Public Health 
Editor, American Journal of Infection Control Columbia University

Joanna Mills RN, MSN, CNS, CIC
Manager, Infection Prevention
John Muir Health System

Sharon Morgan, MSN, RN, NP-C
Senior Policy Advisor
ANA

Margaret (Peg) Pettis RN, MPA, CIC
Infection Preventionist
Rochester Regional Health System

ANA is the premier organization representing the interests of the nation’s 4 million registered nurses. ANA advances the nursing profession by fostering a high standard of nursing practice, promoting a safe and ethical work environment, bolstering the health and wellness of nurses, and advocating on health care issues that affect nurses and the public.

APIC is the leading professional association for infection preventionists (IPs) with more than 15,000 members. APIC’s mission is to create a safer world through the prevention of infection, achieved by better care to promote better health at a lower cost.

Emergency Preparedness | Resources | Consumer specific links | Law, Ethics, and Policy | Additional Resources

What is an emerging infectious disease?

• Deadly Diseases - Ebola, smallpox, anthrax, rabies, and plague; also called “high-consequence pathogens”
• Zoonotic diseases:
• Approximately 75% of recently emerging infectious diseases affecting humans are diseases of animal origin
• Approximately 60% of all human pathogens are zoonotic
• HAIs - At any given time, about 1 in every 25 patients has an infection related to their hospital care
• Infections that are resistant to antimicrobial drugs (like antibiotics)
• Foodborne illness - one in six Americans gets sick each year from something they ate
• Illnesses that affect immigrants, refugees, migrants, expatriates, and travelers—traveler’s diarrhea, hepatitis

Emergency Preparedness

• Disasters, natural or man-made have the potential to amplify emerging diseases or trigger re-emerging diseases
• Maintaining and practicing emergency preparedness plans in the home and workplace can save lives and minimize the spread of disease

Resources

• ANA - Disaster Preparedness & Response
  
  • Hot topics, ie, Zika and Ebola
  • Nurse focused, covers ethics and law as well as clinical information
• APIC - Emergency preparedness
  http://www.apic.org/Professional-Practice/Emergency-Preparedness
  • Links for natural disasters, pandemics, and biohazards
  • Includes information on management of special populations
• CDC - Resources for Emergency Health Professionals
  http://emergency.cdc.gov/health-professionals.asp
  • Focus on communication pathways during an emergency
  • Sub-section for preparedness for specific types of emergencies
• OSHA - Emergency Preparedness and Response
  https://www.osha.gov/SLTC/emergencypreparedness/index.html
  • General guidelines for businesses and first responders
  • Sub-section on specific topics and natural disasters
  • Quick cards and factsheets

Consumer specific links

• CDC - Emergency Preparedness and You
  http://emergency.cdc.gov/preparedness/index.asp
  • “Get a Kit; Make a Plan; Be Informed”
  • Ready Wrigley Pup-- teaching children about what to do in emergency situations
• CDC - Information for Families and Loved Ones of Responders
  https://www.cdc.gov/ebola/about/index.html
  • Resources to assist both responders and loved ones during healthcare or disaster relief deployment
  • Written for Ebola but can be tailored to other situations

Law, Ethics, and Policy

• ANA - Ethics of Disaster Response
  http://www.nursingworld.org/MainMenuCategories/WorkplaceSafety/Healthy-Work-Environment/DPR/TheLawEthicsofDisasterResponse
  • Nurse focused
  • Links to disaster preparedness and nursing duty
• CDC, Public Health Law Program - Emergency Preparedness
  https://www.cdc.gov/phlp/php/trainingandeducationalresources/emergency-preparedness.html
  • Central repository for emergency preparedness-related statutes, regulations, orders, reports, and legal tools
  • Covers hot topics, as well as federal, state, and tribal boundaries
• OSHA Best Practices for Hospital-Based First Receivers of Victims
  https://www.osha.gov/dts/osta/bestpractices/firstreceivers_hospital.html
  • Assist hospitals in developing and implementing emergency management plans that address the protection of hospital-based personnel during the receipt of contaminated victims
  • PDF format

Additional Resources

UNDERSTANDING EMERGENCE AND REEMERGENCE

The Who, What, Where, When & Why

• Barriers to Effective Hand Hygiene
  http://www.medscape.com/ viewarticle/414396_5
• Skin irritation
• Inaccessible supplies
• Interference with worker-patient relation
• Patient needs perceived as priority
• Forgetfulness
• Ignorance of guidelines
• Insufficient time
• High workload and understaffing
• Lack of scientific information
• Gel vs Soap
• CDC - Show Me the Science - When & How to Use Hand Sanitizer
  https://www.cdc.gov/clean-hands/data-research/facts-stats/hand-sanitizer-facts.html
• Hand sanitizers are not effective if your hands are visibly dirty
• With C.difficile, it’s always soap & water
• Hand Drying techniques
  http://europeantissue.com/hygiene/ studies/published-on-mayo-clinic-proceedings-the-hygienic-efficacy-of-different-hand-drying-methods/
• Transmission of bacteria is more likely to occur from wet skin than from dry skin
• From a hygiene viewpoint, paper towels are superior to electric air dryers
• CDC - Clean Hands Count
  https://www.cdc.gov/clean-hands/hcp/clean-hands-count/
• 
  WHO - SAVE LIVES: Clean Your Hands
  http://www.who.int/gpsc/5may/en/

Factors influencing nurse compliance with Standard Precautions

• Exposure to blood and bodily fluids represents a significant occupational risk for nurses
• The most effective means of preventing bloodborne transmission is through adherence to Standard Precautions (SP).
• Despite published guidelines, significant issues remain around compliance with SP to protect nurses from bloodborne infectious diseases.

(AJIC, 2016)

CDC Instructional Videos

• Post Exposure Prophylaxis
• CDC/NIOSH - Bloodborne infectious diseases: HIV/AIDS, Hepatitis B, Hepatitis C
  http://www.cdc.gov/niosh/topics/bbp/emergnedl.html
• WHO - Guidelines on post-exposure prophylaxis for HIV
  https://www.who.int/publications/i/item/9789241506830

CDC: PPE IN HEALTHCARE SETTINGS