The Preventionist

Posted By Chris on November 7, 2010

In case you’ve never developed a personal relationship with your Infection Control Manual, and if no one has ever mentioned it, you should know you really do have one. You might want to locate it sooner rather than later because this manual should contain written policies and procedures  (P & P’s)  or, the rules to the game of Infection Control in your facility.  Surveyors will  ask you:

• To locate it
• When it was last updated
• If the Infection Control Committee has approved and signed off on it
• If it is compliant with recommended and mandatory guidelines
• If you are actually following your policies and procedures (P & P’s)

A good place to begin looking for the Infection Control Manual you have never been formally introduced to is probably down the hall, in an abandoned office, on the bottom most shelf. With some diligence you might spot it leaning against thirty two other misplaced, dusty manuals of one kind or another. You will soon see they all look alike; they are usually large, white, three ring binders that at first glance, seem to have been deliberately designed to be indistinguishable from every other kind of manual.

There are Long-term Care facilities who are right on top of things and know where their Infection Control manual is at all times. They may have invested in multiple copies, and occasionally one may even be found at, or near the nurses’ station, easily accessible. 

Conversely, there are also those facilities that have no idea where to find their manual, or who have multiple editions from extraneous sources such as labs. When vendors change, the manuals are dismissed in favor of the latest provider’s version and so the collection grows until one day, the unfortunate novice Infection Preventionist arrives on the scene, searching for the most recent, updated and compliant manual, only to be faced with an ongoing scavenger hunt.

The Infection Control Manual is more than a resource; its purpose is to contain the Infection Control Policies and Procedures of your facility. They are meant to be based on federal, state and local guidelines, mandates and regulations. These policies and procedures must be reviewed, updated and approved by the Infection Control Committee at least annually and more often as indicated.

In the case of a missing or non-compliant manual, once found, it may be in urgent need of revision. There are companies who produce Infection Control Manuals for Long-term Care, there are labs and other vendors who may supply a LTC with an Infection Control manual, and if the facility is a part of a corporation, there may be the corporate version of Infection Control Policies and Procedures available to you.

The Infection Preventionist needs to locate their facility Infection Control Manual, no matter what state it is in, as soon as possible. Once located, set about updating, editing and revising, with the help of any Infection Control Consultants you may have available to you, your nursing, staff and the Infection Control Committee.  

Categories: Infection Prevention in LTC
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