The Role of an Infection Control Resource Nurse
The Infection Control Resource Nurse (ICRN) program was implemented in the spring of 1993 and was included in the clinical advancement program (CAP) for Medical Center Clinical Services registered nursing staff.

In 1996 the program was expanded to include healthcare professionals from Respiratory Therapy, Occupational Therapy, Physical Therapy and other Clinical Services departments, and was renamed Infection Control Resource Nurse/Professional program.

The ICRN/Ps will have a specified amount of expertise in infection control for the area of specialty involved. The following advantages are to be expected:

1. Unit or department specific infection control policies and procedures will be accurately formulated and revised.
2. Staff practices will be observed and influenced by the ICRN/Ps , ensuring greater adherence to policy and procedures.
3. Changes in technology and equipment will be assessed for infection control implications and appropriate safeguards/observations included in recommended practices.
4. Surveillance data will be augmented by unit-based performance improvement activity to research problems or evaluate interventions.
5. The presence of a "resident expert" will encourage staff interest and access to infection control information.
6. Unit specific infection control information, study results, etc. will be incorporated into the educational programs planned by the educational coordinator (and educational resource personnel).

Specific educational enhancement of the ICRN/Ps will be facilitated by the Infection Control Practitioners , and the Hospital Epidemiologist . This preparation will be accomplished through:

1. Self instructional readings and video viewing
2. Attendance at local infection control meetings, seminars, etc.
3. Attendance at quarterly meetings of the Infection Control Resource Nurse/Professional group. This group will offer educational programs presented by the infection control practitioners, experts from the MUSC Medical Center, and by the ICRN/Ps .
4. Time spent with the Infection Control Practitioners in orientation sessions, making environmental rounds on the units or in the clinics, making educational rounds (and rounds or meetings with other experts - e.g., Infectious Disease physicians, etc.)

The educational expectations include:

1. A basic understanding of the common microbiologic considerations encountered in infection control work.
2. A basic understanding of epidemiological principles of investigation.
3. A thorough understanding of diseases such as Hepatitis B and C, HIV, AIDS, and Standard Precautions as well as steps toward prevention and post exposure treatment.
4. Knowledge of common disease states and risks for patients specific to a particular area of practice. This knowledge would include the use of screening tools to determine risks of TB, chickenpox, pertussis, etc. which would require isolation precautions.
5. Information on risks and appropriate use of technology and other practices specific to the particular practice area.

The expected skills and behaviors include:

1. The ability to read and incorporate information presented in infection control research articles.
2. The ability to present infection control information in educational sessions for staff and other ICRN/Ps (including current and new infection control policies).
3. The ability to conduct basic epidemiologic studies and performance improvement projects and to report on the findings.
4. The ability to observe for adherence to infection control practices and correct (or document) deficiencies in practice.
5. The ability to assist as directed in post exposure activities after staff exposure to certain communicable diseases (e.g., TB, pertussis, chickenpox, meningitis, etc.).

Responsibilities of the ICRN/Ps include:

1. Participation in quarterly ICRN/P meetings
2. Participation in infection control task forces/PI teams specific to their area as need dictates. These task forces/teams would be formed to meet the specific infection control needs of particular areas for as long as the need remains.
3. Participation as needed with other committees (i.e., Service Line, Products, Environment of Care Committees, etc.).
4. Participation in unit meetings, department meetings and/or divisional meetings as appropriate for presentation of information, serving as a resource, soliciting suggestions, direction, etc.
5. Assistance in department/unit specific orientation of new employees in matters relating to infection control practices.
6. Facilitation of meeting IC requirements for PPD skin testing if trained and approved to perform this function for the unit/department.
7. Making rounds with one of the Infection Control Practitioners to monitor infection control practices and assisting with corrective actions.

It has been successfully demonstrated that infection control practices are more consistently incorporated into patient care when these practices arise from information generated at the unit or department level. A great challenge to Infection Control is to be mainstreamed into practice at all levels, instead of "fed" to passive recipients from an "outside" expert.

Daily observation and correction of variance from optimal infection control practices is not realistically possible to be accomplished from a centralized infection control department. The presence and authority of resident experts enhance both patient outcomes and employee safety by education and assistance in ensuring compliance to optimal practice.