Infection Preventionists are Running Dog and Pony Shows

posted Apr 23, 2013, 2:35 PM by Todd Fox   [ updated Sep 23, 2016, 2:50 PM ]
What's your take?
We caught up with a hospital administrator recently and he said, speaking anonymously, "Most infection control programs are just dog and pony shows." It wasn't surprising that he wanted to remain anonymous as he spoke candidly about his experience with infection control managers. The following paragraphs are a few thoughts he used to back up his claim (summarized): 

Most Infection Control Programs are Just Dog and Pony Shows


First of all, it is difficult to trust that the hand hygiene numbers are the real results. Hand hygiene compliance statistics often seem too subjective and based on biases in favor of more seasoned staff members. Our source was not sure if there is some intimidation present that prevents infection preventionists from accurately judging all employees equally. However, he noticed that there is a tendency to automatically assume that all new employees use less hand hygiene. In reality, many new staff members are quick to pick up on guidelines whereas seasoned employees know what to do but are lazy to comply. 

Second, there is problem of management alerting staff members about audits before they happen (whether the infection preventionists are aware they are letting staffers know or not). As most can guess, when auditors are present, everyone acts better. When employees know they are being checked, true hand hygiene numbers are skewed to show favorable results. Anyone can look like a rock star organization when they know they are being scrutinized. 

Third, not enough people care and respect the infection control department or infection preventionist. In certain circles, infection preventionists are likened unto cheerleaders. Always cheering and making noise but they end up not playing a huge part in the overall outcome of the game. Infection control professionals are known to hang signs, hand out treats and have clever activities; however, most information is not retained by the participating staff members. 

Lastly, training is often too general, lacks real consequences and gives the seasoned staff members a break. In general, the seasoned staff members know the compliance guidelines and infection control information- they just need a real compelling reason to comply and need to be led. 

The OUTFOX Prevention Take 


We do not doubt that our source (outspoken health professional) may be rubbing most infection preventionists the wrong way and may be igniting a fierce reaction. For, his opinion does not represent how infection control is perceived in all organizations. 

We have seen the accurate hand hygiene results in many facilities nationwide and have witnessed some impressive infection control programs. So, before taking our source's criticism personal, let’s take what we can from his opinion to see what you can improve upon in your organization. The following are some general points that you can use to upgrade your infection control program: 

  • In regards to infection preventionists being cheerleaders, it doesn't have to be that way. You can make a difference and change the culture of the organization to be more aware and responsible. Being a leader includes having a cheerleader role, but your role as a leader needs to include much more. People naturally gravitate towards leaders and the direction that is being set by leaders. To get your staff members to follow you, it is not enough to appeal to them with the compliance numbers, have catchy/funny phrases or hand out treats. Engage them and inspire them- not be the circus. 
  • You need full integration and support of staff members on all levels- from executives to part time staffers. Executives and upper management usually are generally supportive, but they need to be more proactive with their support. One main executive should step up and be the mouthpiece/co-mouthpiece of your program(s). Be unwavering in your request for management support. 
  • Integrity within an infection control program is key. Do what you say and do it fast. Too often goals and rewards are set up as stepping stones that are either too easy or hard to accomplish. In reality, it is difficult to create goals that are attainable without being too easy. I have witnessed many goal programs that promise certain rewards but then management backtracks when the team steps up and outperforms.  Changing goals in the middle of an initiative is detrimental and kills motivation. If goals need to be retooled, finish out the program for a time and then readjust. On the opposite side of the spectrum, we have seen where goals are too difficult to accomplish and the program fizzles quickly. Find a balance. 
  • Along the topic of goal setting in infection control programs, have attainable certifications (even if they are internal certificates) that are tied to trainings. These certifications and advancement levels will help keep motivation going in regards to infection control. Create tests, printed certificates, renewal certificate programs, advancements opportunities, etc.  Ideas for the certifications include basing the certification process on online tests, Glo Germ trainings, textbooks, infection control terminology, new equipment processes and other general systematic areas (air/water purification, donning and glove removal, gown removal, Personal Protective Equipment (PPE), standard precautions, CDC guidelines, etc.). 

It you would like more information that can help your infection control programs succeed, see the following links: 

Standard Precautions 
Glo Germ Hand Hygiene Trainings 
Environmental Cleaning Verification Training (Fluorescent) 
The OUTFOX Program


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