Required online readings & websites listed on the syllabus can be accessed by
clicking on ... http://www.who.int/gpsc/country_work/summary_20100430_en.pdf.
Course Syllabus
PubH 7230 Section 102 Class #87623 Infection Prevention across the Spectrum of Health Care Settings: Global Strategies that Apply to Humans and Animals May Session 2013 Credits:
1 Credit
Meeting Time:
June 3, 4, 5 June 7
Meeting Place:
Blegen Hall 435
Instructors:
Jeff Bender DVM, MS DACVPM Professor College of Veterinary Medicine/School of Public Health Hospital Epidemiologist
1:00 - 5:00 pm 1:00 - 4:00 pm
Jeanne Pfeiffer, DNP, MPH, RN, CIC Clinical Assistant Professor School of Nursing, University of Minnesota Office Address:
1354 Eckles Ave St Paul, MN 55108
Office Phone:
(612) 625-6203
E-mail:
[email protected] [email protected]
Office Hours:
By appointment
I.
Course Description Infection control practices can greatly reduce hospital associated infections. The goal of infection prevention is to protect the patient and protect the care giver and visitors in a cost-effective manner. This course is designed to provide participants with an overview of contemporary infection prevention and control practices for a variety of settings. This includes broad application globally and to both human and veterinary environments.
II. Course Prerequisites Students will be expected to read introductory materials and to complete a pre course self assessment of course content and application prior to class.
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III. Course Goals and Objectives These goals and objectives will include discussions of human, veterinary and global health issues. Upon completion the course, students will be able to:
List important components of hospital/clinic based infection prevention and control (IPC) program Understand areas of risk to the host such as surgical site, IV and urinary catheters and ways to prevent infection Describe the influence of the environment on the risk of infection. This includes geographic issues that may impact resource availability. Design and evaluate surveillance activities in specific settings (veterinary clinic, human hospital, and resource settings) Describe the advantages and disadvantages of the various methods for disinfection and sterilization Discuss the relationship between IPC practices and prevalence of multi-drug resistant organisms.
Methods of Instruction and Work Expectations The course is designed to integrate discussion and interaction of students on the multiple knowledge areas of infection prevention and control: epidemiology, microbiology, infectious disease, environmental sanitation, patient care practices, and organizational management through lectures, case studies, class discussion and a written paper. Students will be expected to spend about 2 hours reading assigned materials or reviewing pertinent materials and/or working on a group project before each class. Pre and post course assessments will be administered to students on line (10% of grade) Class participation will be assessed by attendance and participation in in-class learning activities. (10% of grade) Quizzes will be administered on-line through the Moodle site. A pre-assessment quiz will be done to determine student understanding of topic areas and guide course content. A follow-up quiz will be given mid-course to assess student’s understanding of basic concepts. (20% of grade) Case study/Group Project: Students will be asked to pick a disease of concern (example: rabies, Ebola, MRSA, Clostridium difficile, Norovirus, Influenza) or an area of concern in infection control such as surgical site, intravascular, respiratory infections. o o
o o o
Groups of 3 to 5 students will be assigned to a disease topic. Each group will prepare a 20 – 30 minute PowerPoint presentation regarding their disease topic area. (40% of grade) This will include a brief description of the disease, surveillance approaches, response to detection, and recommendations for prevention and control. Groups will be encouraged to discuss a “real life” case study to document the impact of the disease and discuss infection control practices employed. The group will also prepare a fact sheet regarding their disease topic. Please identify the intended audience (health care practitioners, veterinarians, general public). (20% of grade) The goal of this assignment is to help broaden student perceptions, practice devising recommendations and presenting key information. Conciseness, neatness and clarity of work are important.
IV. Course Outline/Weekly Schedule Pre-Course
Assignments: 1. Take the online pre-assessment survey (5 pts). 2. Students are strongly encouraged to read materials located on Moodle site in preparation for activities during the day to gain an understanding of content related to: 1) Terminology
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2) In class discussions among classmates with varied backgrounds 3) Knowledge and skills required to prepare group projects. Day 1 - June 3
Welcome, Introductions, and Participant Goals (attendance and in class participation (0 pts)
Infection Control Programs
Definitions and terms
Case examples
Management, staffing, infrastructure, education
Criteria for effective IPC program
Protection of staff
Risk areas in healthcare
Surgical sites Urinary catheters IV catheters Needlesticks
Case study and Group project assignment Moodle Quiz 1 (10 pts) Day 2 – June 4
Epidemiology: review/Outbreak Investigations
Role of the environment • Case study assessment Surveillance Day 3 – June 5
systems, definitions, data analysis, presentation,
Prevention of HAI Hand hygiene Patient care practices (Isolation, cohorting) Anatomical sites Procedure related _____________________________________________________________________ Sterilization, Disinfection, Sanitation: Principles, Application, Technologies and Monitoring ______________________________________________________________________ Organisms of concern
Multi-drug resistant organisms (MDRO) Antibiotic stewardship
Quiz 2 (10 pts) Student Group Project Time
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Day 5 – June 7
Student Group PP presentations (40%)
(no class on June 6)
Student Presentation of Fact Sheets developed on above topic for specific audience at risk of disease (20%) Take the online post assessment survey (5 pts) Evaluation of IPC Programs
V.
Course Text and Readings
Required online readings & websites listed on the syllabus can be accessed by clicking on the weblink, if provided. Journal articles and other readings are available as PDF documents on the Moodle site associated with this course. Or, you can access them through PubMed or the University Libraries (see instructions listed below). Students are responsible for downloading all course materials and completing pre-course assignments. Access Course Moodle Site
go to www.umn.edu click on the “myU” button login with your University ID and password scroll to your course and click on the Moodle site link.
Access PubMed
go to the PubMed website at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi Type in the PMID number listed on the course materials, click the go button This takes you to a citation page, click on the author name This takes you to the abstract page, click on the journal title button This takes you to the full journal article
Access University Libraries
Go to the U of MN libraries website at http://www.lib.umn.edu/#articlesanddatabases Type in the journal title in the “Search For” box, click the go button This takes you to a list of possible journal titles, click on the title you want This takes you to a search form, fill in citation information, click the go button You will be prompted to login with your X.500 number and password This will take you to the journal and the abstract of the article Find on the page where it says Full Text or PDF (it is different for each journal), click on that and the full text will open. journal), click on that and the full text will open.
About the course readings: Epidemiology: The readings are listed as recommended and optional. Many students have taken epidemiology courses and may need only a quick review. Course participants who have not had epidemiology courses are encouraged to read all chapters in the recommended listing. The Internet sites in the optional reading listing are available for your use. Cleaning, Disinfection, Sterilization Please review the Guidelines for Disinfection/Sterilization. This is an important resource. The issues of cleaning, disinfection, sterilization limit the successes of both low and high technology. Healthcare processes and devices
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Required Reading Course Materials: World Health Organization (WHO): nd Prevention of hospital acquired Infections: A practical guide. 2 edition, Chap II Infection control programmes http://www.who.int/csr/resources/publications/drugresist/WHO_CDS_CSR_EPH_2002_12/en/ nd
Prevention of hospital acquired Infections: A practical guide. 2 edition, Introduction, pp 4-9 http://www.who.int/csr/resources/publications/drugresist/en/whocdscsreph200212.pdf Centers for Disease Control (CDC): National Healthcare Safety Network (NHSN) Report, data summary for 2006 through 2007, issued November 2008, http://www.cdc.gov/nhsn/PDFs/dataStat/2009NHSNReport.pdf Graves N. Economics and preventing hospital-acquired infection. Emerg Infect Dis [serial online] 2004 Apr Available from: http://www.cdc.gov/ncidod/EID/vol10no4/02-0754.htm Cleaning, Disinfection, Sterilization World Health Organization (WHO) Prevention of hospital-acquired infections: A practical guide. Chapter 5.3 Preventing transmission from the environment http://www.who.int/csr/resources/publications/drugresist/WHO_CDS_CSR_EPH_2002_12/en/
Centers for Disease Control Rutala WA, Weber DJ, and the Healthcare Infection Control Practices Advisory Committee (HICPAC)3 Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008 http://www.cdc.gov/hicpac/pdf/guidelines/Disinfection_Nov_2008.pdf
International Infection Control – The Big 4 World Health Organization (WHO) The burden of healthcare-associated infections worldwide: A summary http://www.who.int/gpsc/country_work/summary_20100430_en.pdf Catheter Associated Urinary Tract Infections (CaUTI) World Health Organization (WHO) nd Prevention of hospital acquired Infections: A practical Guide. 2 edition Chap 1.2.1 Urinary infections Chapter 6.1 http://www.who.int/csr/resources/publications/drugresist/WHO_CDS_CSR_EPH_2002_12/en / Central Line Associated Blood Stream Infections Centers for Disease Control and Prevention (CDC) U.S. Centers for Disease Control and Prevention. (2002). Guidelines for the prevention of intravascular catheter-related infections. http://www.cdc.gov/mmwr/PDF/rr/rr5110.pdf World Health Organization nd Prevention of hospital acquired Infections: A practical Guide. 2 edition Chap 1.2.4; Chapter 6.4 http://www.who.int/csr/resources/publications/drugresist/WHO_CDS_CSR_EPH_2002_12/en /
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Ventilator Associated Pneumonia (VAP) World Health Organization nd Prevention of hospital acquired Infections: A practical Guide. 2 edition Chap 1.2.5 Nosocomial pneumonia; Chapter 3.1 http://www.who.int/csr/resources/publications/drugresist/WHO_CDS_CSR_EPH_2002_12/en / Surgical Site Infections (SSI) Centers for Disease Control and Prevention (CDC) Report http://www.cdc.gov/nhsn/PDFs/dataStat/2008NHSNReport.pdf [also in readings for Infection Control Program] World Health Organization nd Prevention of hospital acquired Infections: A practical Guide. 2 edition Chap 1.2.2 Surgical site infections; Chapters 6.2;6.2.1;6.2.2;6.2.3;6.2.4;6.2.5; http://www.who.int/csr/resources/publications/drugresist/WHO_CDS_CSR_EPH_2002_12/en / Other Factors Infection Prevention Programs Road Map to a Comprehensive Healthcare-Associated Infection (HAI) Prevention Program http://www.mnreducinghais.org/documents/HAIRoadmap.pdf Safe Injection Practices The One & Only Campaign is a public health campaign, led by the Centers for Disease Control and Prevention (CDC) and the Safe Injection Practices Coalition (SIPC), to raise awareness among patients and healthcare providers about safe injection practices. Video 4.25 minutes http://www.youtube.com/watch?feature=player_embedded&v=6D0stMoz80k http://www.oneandonlycampaign.org/news/new-tools-help-clinicians-ensure-every-injection-safe Hand Hygiene The World Health Organization has created an innovative training tool sponsored by DebMedical Healthcare Group “The WHO 5” Hand Hygiene Rap Video 6 minutes. http://www.youtube.com/watch?v=GGfWUf97VHg Environment Centers for Disease Control Healthcare- Associated Infections: Recovery Act-Options for Evaluating Environmental Cleaning http://www.cdc.gov/hai/toolkits/evaluating-environmentalcleaning.html Antibiotics Minnesota Guide to a Comprehensive Antimicrobial Stewardship Program 9/19/2012 http://www.health.state.mn.us/divs/idepc/dtopics/antibioticresistance/mnasp.pdf
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Additional Resources: EPIDEMIOLOGY World Health Organization nd Prevention of hospital acquired Infections: A practical Guide. 2 edition Chap III Nosocomial Infection Surveillance http://www.who.int/csr/resources/publications/drugresist/WHO_CDS_CSR_EPH_2002_12/en/ accessed May 11, 2009 The APIC text (2nd ed.)
Friedman C. (2009). Infection prevention and control programs. In R. Carrico (Ed.). The APIC text rd (3 ed.), (pp. 1-1.1-1-8). Washington, DC: Association for Professionals in Infection Control.
Tweeten,SM. (2009). General principles of epidemiology. In R. Carrico (Ed.). The APIC text, (3rd ed.), (pp. 2.1-2.14). Washington, DC: Association for Professionals in Infection Control.
Srinivasan A. (2009). Outbreak investigation. In R. Carrico (Ed.). The APIC text (3 4.1-4.10). Washington, DC: Association for Professionals in Infection Control.
Potts A. and Wilson AC. (2009). Use of statistics. In R. Carrico (Ed.). The APIC text, (3rd ed.), (pp. 5.1-5.20). Washington, DC: Association for Professionals in Infection Control.
Arias KM. (2009). Surveillance. In R. Carrico (Ed.). The APIC text, (3rd ed.), (pp. 3-1 to 3-17). Washington, DC: Association for Professionals in Infection Control.
Fry RJ and Howard JJ. (2009). Surgical site infections. In R. Carrico (Ed.). The APIC text, (3rd), (pp. 23.1–23.11). Washington, DC: Association for Professionals in Infection Control
rd
ed.), (pp.
VII. Evaluation and Grading Class participation (10%) Quizzes (20%) Case study/Group Project (40%) Fact sheet (20%) Pre and post course assessment (10%) Grading Criteria: This course is offered A/F or S/N A/F letter grade will be determined by total effort as follows: A = 90-100%
(4.0) Represents achievement that is outstanding relative to the level necessary to meet course requirements.
A- = B+ = B = 80-90%
(3.0) Represents achievement that is significantly above the level necessary to meet course requirements.
B- = C+ = C = 70-80%
(2.0) Represents achievement that meets the minimum course requirements.
C- = D+ = 7
D = 60-70%
(1.0) Achievement below minimum course expectations but sufficient to be awarded credit.
D- = F = below 60%
• S
Represents failure (or no credit) and signifies that the work was either (1) completed but at a level of achievement that is not worthy of credit or (2) was not completed and there was no agreement between the instructor and the student that the student would be awarded an I.
S/N option must complete all assignments to a C- level (70%): Achievement that is satisfactory will be expected to complete all assignments and receive a minimum of 70% to receive a passing score (achievement required for an S is at the discretion of the instructor but may be no lower than a 70%).
N
Represents failure (or no credit) and signifies that the work was either (1) completed but at a level of achievement that is not worthy of credit or (2) was not completed and there was no agreement between the instructor and the student that the student would be awarded an I.
PLEASE NOTE: If applicable, students may change grading options during the initial registration period or during the first two weeks of the term. The grading option for a Public Health Institute 4-day course may not be changed after the second day of class. Or, after the first day of class for a 2-day course. Incomplete Contracts A grade of incomplete “I” shall be assigned at the discretion of the instructor when, due to extraordinary circumstances (e.g., documented illness or hospitalization, death in family, etc.), the student was prevented from completing the work of the course on time. The assignment of an “I” requires that a contract be initiated and completed by the student before the last day of class, and signed by both the student and instructor. If an incomplete is deemed appropriate by the instructor, the student in consultation with the instructor will specify the time and manner in which the student will complete course requirements. Extension for completion of the work will not exceed one year (or earlier if designated by the student’s college). For more information and to initiate an incomplete contract, students should go to: www.sph.umn.edu/grades. University of Minnesota Uniform Grading and Transcript Policy A link to the policy can be found at onestop.umn.edu. Course Evaluation Beginning in fall 2008 the School of Public Health will collect student course evaluations electronically using a software system called CoursEval. The system will send email notifications to students when they can access and complete the course evaluations. Students who complete the course evaluations promptly will be able to access their final grades just as soon as the faculty member renders the grade. All students will have access to their final grades two weeks after the last day of the semester regardless of whether they completed the course evaluation or not. Student feedback on course content and faculty teaching skills are important means for improving our work. Please take the time to complete a course evaluation for each of the course for which you are registered. VIII. Other Course Information and Policies Grade Option Change (if applicable) For full-semester courses, students may change their grad option, if applicable, through the second week of the semester. Grade option change deadlines for other terms (i.e. summer and half-semester) can be found at onestop.umn.edu. The grading option for Public Health Institute courses may not be changed after the second day of class for 4-day courses. Grading options for 2 day courses may not be changed after the first day class. 8
Course Withdrawal Students should refer to the Refund and Drop/Add Deadlines for the particular term at onestop.umn.edu for information and deadlines for withdrawing from a course. As a courtesy, students should notify their instructor and, if applicable, advisor of their intent to withdraw. See section below for rules about Public Health Institute courses. Students wishing to withdraw from a course after the noted final deadline for a particular term must contact the School of Public Health Student Services Center at
[email protected] for further information
WITHDRAWAL POLICY FOR PUBLIC HEALTH INSTITUTE COURSES School of Public Health students may withdraw from a 4-day course through the second day of class without permission and no “W” will appear on the transcript. Students enrolled in 2-day courses may withdraw only through the first day of class. After these withdrawal deadlines pass students are required to do the following.
The student must contact and notify their advisor and course instructor informing them of the decision to withdraw from the course.
The student must send an e-mail to the SPH Student Services Center (SSC) at
[email protected]. The email must provide the student name, ID#, course number, section number, semester, and year with instructions to withdraw the student from the course, and acknowledgement that the instructor and advisor have been contacted.
The advisor and instructor must email the SSC acknowledging the student is canceling the course. All parties must be notified of the student’s intent.
The SSC will complete the process by withdrawing the student from the course after receiving all emails (student, advisor, and instructor). A “W” will be placed and remain on the student transcript for the course. Student Conduct, Scholastic Dishonesty and Sexual Harassment Policies Students are responsible for knowing the University of Minnesota, Board of Regents' policy on Student Conduct and Sexual Harassment found at www.umn.edu/regents/polindex.html. Students are responsible for maintaining scholastic honesty in their work at all times. Students engaged in scholastic dishonesty will be penalized, and offenses will be reported to the Office of Student Academic Integrity (OSAI, www.osai.umn.edu). The University’s Student Conduct Code defines scholastic dishonesty as “plagiarizing; cheating on assignments or examinations; engaging in unauthorized collaboration on academic work; taking, acquiring, or using test materials without faculty permission; submitting false or incomplete records of academic achievement; acting alone or in cooperation with another to falsify records or to obtain dishonestly grades, honors, awards, or professional endorsement; or altering, forging, or misusing a University academic record; or fabricating or falsifying of data, research procedures, or data analysis.” Plagiarism is an important element of this policy. It is defined as the presentation of another's writing or ideas as your own. Serious, intentional plagiarism will result in a grade of "F" or "N" for the entire course. For more information on this policy and for a helpful discussion of preventing plagiarism, please consult University policies and procedures regarding academic integrity: http://writing.umn.edu/tww/plagiarism/. Students are urged to be careful that they properly attribute and cite others' work in their own writing. For guidelines for correctly citing sources, go to http://tutorial.lib.umn.edu/ and click on “Citing Sources”. In addition, original work is expected in this course. It is unacceptable to hand in assignments for this course for which you receive credit in another course unless by prior agreement with the instructor. Building on a line of work begun in another course or leading to a thesis, dissertation, or final project is acceptable. If you have any questions, consult the instructor.
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Disability Statement It is University policy to provide, on a flexible and individualized basis, reasonable accommodations to students who have a documented disability (e.g., physical, learning, psychiatric, vision, hearing, or systemic) that may affect their ability to participate in course activities or to meet course requirements. Students with disabilities are encouraged to contact Disability Services to have a confidential discussion of their individual needs for accommodations. Disability Services is located in Suite180 McNamara Alumni Center, 200 Oak Street. Staff can be reached by calling 612/626-1333 (voice or TTY).
Mental Health Services As a student you may experience a range of issues that can cause barriers to learning, such as strained relationships, increased anxiety, alcohol/drug problems, feeling down, difficulty concentrating and/or lack of motivation. These mental health concerns or stressful events may lead to diminished academic performance or reduce a student’s ability to participate in daily activities. University of Minnesota services are available to assist you with addressing these and other concerns you may be experiencing. You can learn more about the broad range of confidential mental health services available on campus via the Student Mental Health website at http://www.mentalhealth.umn.edu
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