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Infection Control, Employee Health & TB
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smilingbig has 6 years experience and specializes in Infection Control, Employee Health & TB.

smilingbig's Latest Activity

  1. smilingbig

    CIC exam

    When are you taking your CBIC exam?
  2. smilingbig

    Eight or 12 hour shifts

    My acute nursing experience that I had prior to leaving the ‘bed-side' included cardiovascular/telemetry/step-down. But that was only about 1 1/2 -2 years. I then started working for the health district running their tuberculosis program. Having knowledge about TB really helped me land my first official Infection Preventionist job because I was responsible for the Medical ICU/ CVICU and several medicine units. So don't discount the knowledge that you bring to the table. Having an understanding of how any health departments works (the beast that it can be;)), how to investigate outbreaks/exposures in the community, having a thorough understanding of the community demographics will really be beneficial for you (it was for me). Your understanding of employee health/immunization standards will actually come in handier than you may think… everything that you do seems to qualify you to sit for the CBIC exam. Have you looked into that? Eligibility Requirements | CBIC: Certification Board of Infection Control and Epidemiology, Inc. If you are able to become certified, you will definitely be more marketable, regardless of your experience in the hospital environment. You have the educational foundation to apply infection control/prevention standards anywhere you would work. While I didn't have all the hospital IC/IP experience when I started there, the others that I worked with were eager to learn from me and I from them. The health department was really a great start for me.
  3. smilingbig

    Eight or 12 hour shifts

    I've been working in IC/IP for about 5 years and only for 2 different facilities. Both of my facilities are quite different, and the position of IP/IC nurse has permitted me quite a bit of flexibility as far as schedule goes. For the most part, I haven't worked weekends for the past 5 years. There was only one time that I offered to come in one Saturday to meet with a family to do some education about a CRE infection in a family member. As far as 8 or 12 hours shifts, in both of my positions I (along with others in my department) was given the liberty to work 40 hours however we wanted. For the most part we had some early risers that preferred to come in 6-3, and then we had those that preferred to sleep in so they worked 10-7. Our boss was very easy going and allowed us to flex our hours as long as one of us was in the office between the hours of 8-5. She even permitted working from home a few hours on days when we were not going into the office due to personal appointments. Right now I work for a 50 bed Inpatient Rehabilitation Hospital (IRF). We have an inpatient therapy gym on each floor with 25 patient beds. We also have a therapy pool and outpatient gym on our ground floor. These things offer different infection control/prevention opportunities/risks than a typical inpatient acute facility. I conduct daily (sometimes more) rounding to do hand hygiene/PPE observations, and conduct surveillance for any infection control concerns. I review all cultures on all patients daily and order isolation if it has not already been done. I will also meet with patients/family to do education on any organisms and also discuss the importance of hand hygiene. I conduct daily surveillance on all invasive lines (foleys/CVCs-we don't have vents at this time) to make sure that the nurse is documenting the continued necessity (or that it is being removed or to be discussed with the provider) and that the physician also documents the medical necessity. I am the co-chair for our Infection Control Committee (ICC) so I prepare all the data/charts/presentations for that. I also review any policies that may need amending and write proposed changes for them to present to the ICC meeting. I present at general hospital orientation the IC/IP information. I participate in EOC rounds and several committees representing and driving the IP/IC components. I am also the Employee Health Nurse & Workers' Compensation Champion. So I manage that as well, reviewing all new hires immunizations, drawing blood for titer checks, conducting fit testing, reporting any injuries, reviewing and managing any WC claims. As far as my hours go, I work whenever really. My boss is very flexible, but I prefer to come in early to get the night shift nurses if I need to do any training/immunization with them. I also flex my hours if it is needed to adjust for the census. It's actually quite a bit, but that is it (in a nutshell) for where I am currently working. See the link below when I posted about where I used to work. I would still be working there had I not needed to relocate for my spouse's employment. I love IP/IC world… and can't imagine ever leaving this kind of nursing. Good luck to you!! https://allnurses.com/infectious-disease-nursing/becoming-an-infectious-775679.html#post6937961
  4. You technically don't need hospital IP experience specifically. I actually know several people that belong to my APIC chapter that work for the state in different epi departments and are CIC. I would print out your job description and verify it directly with the CBIC eligibility requirements. If there are things that you do that are not specifically mentioned in your job description you should speak with your supervisor to see about amending the job description so that it is correct and reflective of tasks that could qualify you to sit for the exam. Also, they change to be more specific starting July 1st (you probably know this) so make sure that you look at your job description and compare it the the appropriate eligibility requirments based upon when you are planning on taking it. From my understanding, I would think that you would qualify on their 4th component specifically in the areas of management and communication & education and research. Seems like semantics, but I know that you manage 'outbreaks' and communicate your findings to prevent/limit exposures. I would see if you can email them to ask; I imagine they would be forthcoming if they felt that your job description was lacking in a certain area. Good luck!
  5. smilingbig

    Xenex X machine

    We had this in the last acute care hospital I worked at. I hope you were able to find some of the published research supporting reduced HAIs. I came across a bunch! It's relatively new technology so research that has been done is really starting to show some excellent trends. Keep in mind it doesn't replace cleaning, but is an adjunct to the sanitation process. I even saw a report on it improving HCAPS scores because they made an effort to educate patients on the extra mile they were going to make sure they were safe. Be sure and pay attention to how they test for evidence that it works. Swabs that are cultured should be pretty reliable if they were obtained the same way. But, if ATP swabs are done your counts will go up after xenon just by the nature of how it kills. It pulverizes the organisms into many smaller pieces.
  6. smilingbig

    What is Infectious Disease Nursing?

    I think it was meant to be; it's all semantics. As far as I know, the only nurses that I know that work in "Infectious Disease" work in an office for an Infectious Disease doctor. Infection Control Nurses are usually referred to 'Infection Preventionists.' Although, not all IPs are nurses.
  7. smilingbig

    Good text for learning immunology?

    Thank you! Perhaps that video is helpful... I'm surprised how misunderstood TB is amongst many medical professionals I encounter. If you ever need additional resources for TB there are regional TB centers throughout the US that have TONS of info on their websites.
  8. smilingbig

    Good text for learning immunology?

    As an infection control nurse I've only needed to know the basics, but my husband is graduating med school in a couple weeks and had to be well versed in this. I know before medical school he had used Immunology Made Ridiculously Simple. While in school he just used the SOM Scribes that the previous year's med students published (basically class notes). He also has this website book marked that was widely shared amongst his colleagues Learn Immunology Easily for the USMLE Step 1 - Medical School Memoirs Hope that helps! Good luck to you!
  9. smilingbig


    I haven't taken the exam yet, but my entire department (6 IPs) has been studying for the exam. We (with the guidance of our CIC director) have been using the APIC text & review outline to go over the materials. The text has actually been revised and the lastest edition should be released this summer. We've also used The IPs guide to the lab. One of my team members has been doing the online review course and said that has been very helpful. I plan on starting that within the next year. She has 4 more years of infection control experience than I do... she's going to be ready to test within the next few months. Good luck on getting the job!
  10. smilingbig

    Infection control concern in NICU

    I just wanted to point out a few things.... Acinetobacter are bacteria that are naturally occurring in soil and water; so unfortunately, there is a great chance that just about every staff member at your facility is carrying that around on their shoes. Which leads me to my next point... A staff member that picks up ANYTHING off the floor and places it ANYWHERE without thoroughly cleaning it has just created an infection control issue. I've come across many hospital staff members in my career that fail to understand that if it is on the floor or touches the floor it is dirty. Also, standard precautions and isolation precautions are implemented to prevent the spread of organisms. If hand hygiene, standard & isolation precautions are being adhered to this will prevent the spread of organisms. So the hypothetical situation that you have described is centered around a staff member that wouldn't adhere to simple infection control principles which I am sure are part of your institution's policy (somewhere). Management is going to assume that all nurses are going to adhere to these policies no matter their location. I do completely agree with you that it would be best to have a closed unit. I was not able to find any literature that supported the points that you made. You may want to contact the previous hospital you worked at to see if they have references that you can provide your manager. I did find an article that correlates increased HAIs to units that have poor staffing and utilize float nurses often. (http://cid.oxfordjournals.org/content/47/7/937.full.pdf+html) I don't know if that will be helpful. I don't know what state you live in, but you may want to look at your nursing practice act. If it has been awhile since you have cared for that type of patient population, it may not be safe for you to do so because your knowledge and skill set is now more focused on the NICU population. In Texas, our NPA doesn't not address staffing directly, but does state that as a nurse I am required to only accept an assignment that is within my education/training/experience. See below... http://www.bon.texas.gov/practice/faq-floating.html So, you may have an argument there. Good luck in trying to make changes to your unit!
  11. smilingbig

    Disinfecting electric shavers

    I would contact the manufacturer of the electric shaver for instructions on what kinds of solutions/materials are approved to clean the different surfaces of the clipper/shaver. Depending on the type of metal, there are certain cleansers that can be abrasive and/or corrosive creating potential infection control issues. I agree with Sweet_Wild_Rose, disposable blades are the way to go. I double checked with our Infection Prevention Nurse that covers our High Level Disinfection/Sterilization procedures/policies and she stated that ALL our policies for cleaning any kind of reusable equipment are EXACTLY the standards that the manufacturer has established and reference the manufacturer as the source of information. Hope that helps!
  12. I don't mind questions at all, if you don't mind the delayed reply :) However, I think the school to which you are applying is different than what we were referring to in this thread. While the RN to BSN program was a second undergraduate degree for me since I already had a BA in a different area, it is not their "2nd degree BSN." I had already earned my ADN-RN prior to starting the RN to BSN program. So, I can't really comment on the challenges of their "2nd degree BSN" coursework. My pre-requisites were a combination of on-line and in-class courses. Since all of the institutions I attended were in Texas I was able to verify that they were transferrable through the Texas Common Course Matrix. Luckily I didn't have to retake any courses. Sorry, it sounds like I wasn't much help. Good luck though!!
  13. smilingbig

    How to land an infection preventionist position

    APIC's educational offerings are tailored to Infection Preventionists/Practitioners so they are perfect for what you want to go into. When I first started in IC I found them instrumental in creating a foundation for me to build on. If the position that you are applying for is an entry-level IC position, they do not expect you to have any specific IC knowledge, although it would certainly be helpful. I have come across some online nurse CE websites ( nurse.com-you pay about $45) that have some organism-specific CEUs that have some very good information regarding the drug resistant organisms that we are concerned about. You may want to gain a good understanding of these organisms and the mechanisms/processes that make them resistant & how they can be spread/controlled. They also have some good classes on general infection control/hand hygiene/EID/immunizations/etc. (For 1 CEU per class, not bad for $45.) Like the previous person had commented there are different ways that facilities fulfill the requirement for IC/IP. Some are associated with their quality management departments; at my facility we have our own department, Healthcare Epidemiology. There are 6 of us and we are all assigned ICUs and procedures to conduct surveillance on for HAIs. All inpatient facilities are required to report HAIs whether central line/ foley catheter/ventilator/surgical site related. Having a general understanding of NHSN (National Healthcare Safety Network) and different required reportable infections may be a good idea. Also, some states have different requirements for reporting HAIs... NHSN has a link to see those state specific requirements. I had commented on one of these threads before about when we had conducted panel interviews for a new IP in our department. Being willing & eager to learn and a team player are two of the most important factors that we looked for. We realize that not everyone is going to know the principles of conducting a TB exposure or how to collect denominator data for surveillance purposes, but it is critical to have someone who is willing to learn all that and work with folks that have experience in the field who are willing to teach (especially when new to the field). The fact that you have ICU experience is a huge plus. There is a lot of chart review that we do that having a great understanding of patient symptoms/condition will make your job easier to do. I came into Infection Control/Epidemiology from the TB world. I worked as a TB program manager/nurse so my experience working exposures and having a thorough understanding of TB really helped me. Since TB is a reportable disease I would be the person that my facility had contacted to report any suspected or confirmed cases of TB. So, I wasn't exactly a stranger to them when I had applied. Although, I did have some serious competition to get this job. I have since found out how sought after an IP/IC positions are. I hope I wasn't too late in my reply.... Good luck with nailing the job:up:!!
  14. smilingbig

    Disgusted in GA:Used ice paks in the freezer

    Wow... It amazes me that these nurses have the time to go through the trouble to label, bag, and return to the freezer something that is typically deemed "single-use." Cost aside, if a manufacturer states something is single use it needs to be used appropriately (as you have tried so hard to make happen). I would just verify that this is what the manufacturer has set. If the manufacturer has said that these are reusable. They will have set standards for how they are to be cleaned and stored after being used. If JC were to come and they were to ask about this, the staff would need to be able to speak to this process. So, if they can be cleaned, stored and reused the recommended process needs to be implemented and followed (if this is the direction that you guys choose to go). As a nurse in infection prevention/control I cannot believe that the infection control nurse suggested to get another freezer!?!?!?! The point was clearly lost on them. The manager needs to change policy or create a new policy addressing this and communicate this to every staff member. They need to understand that this is a part of their minimum job expectations (patient safety!!) and staff members should be held accountable for not meeting this standard (whether they are single use or used, cleaned and reused). I've found that the most compliance with these kinds of things comes when an employee understands their will be consequences for deficiences (aside from possible nosocomial infections). When you have patients possibly getting infections due to actions that the nurses are taking...you stop the actions. It seems rather simple, I know. If you don't have any further luck I would definitely get the neurosurgeons involved. They don't want their patients to have to deal with infections, whatever the source. So they should provide some additional pressure to get the standards set and followed. Just as a side note... Neuro surgeries are not currently a procedure that is part of the reporting requirement of nosocomial surgical site infections to CMS via NHSN but that doesn't mean that they won't become a reportable procedure in the future. (Although I'm sure if it was already a reportable surgery you wouldn't even be addressing this as it would have already been a resolved issue.) Good luck with getting the changes implemented! I applaud your efforts in taking this on!
  15. smilingbig

    Precautions for hepatitis?

  16. smilingbig

    RN Salary Survey 2013: Post here!

    1. TX 2. 4 yrs 3. Large academic public hospital (I cover 2 ICUs & 5 other medicine units) 4. 69,550 5. N/A- we don't work nights/weekends/holidays(paid off:)) 6. Never