Infection Prevention and Control is at a Crossroads of Complex Challenges Ahead
By Kelly M. Pyrek
As the Association for Professionals in Infection Control and Epidemiology (APIC) celebrates a half century of protecting patients and healthcare personnel through the efforts of infection prevention and control (IP&C) and risk management, we examine the journey of the field and the profession as it evolves and impacts the entirety of the healthcare landscape.
In 1970, the Centers for Disease Control and Prevention (CDC) established the National Nosocomial Infections Surveillance (NNIS) System, now known as the National Healthcare Safety Network (NHSN), which is used to report and track healthcare-acquired infections (HAIs). It created the bedrock upon which modern public health efforts were built. With epidemiological structures beginning to take shape, nurse epidemiologists and infection control nurses began to outline the beginnings of what would eventually become the infection preventionist (IP) profession in the early 1970s. APIC was founded in 1972 by a small group, led by pioneers such as Carol DeMille, Pat Lynch, Kay Wenzel, and other visionaries.
“The thing I'm most proud of is the persistence and the determination of not only the individuals who are members of APIC, but anyone in the profession of infection prevention and control,” says current APIC president Linda Dickey, RN, MPH, CIC, FAPIC, interim senior director for quality, patient safety and infection prevention at UCI Health in Orange County, Calif., who adds, “Especially in talking with the earlier founders of APIC and then also having some perspective of putting them in practice for almost 30 years. It's taken a lot to continue to push forward with reducing infection risks. I marveled when I learned more about the beginnings of APIC and how there was no infrastructure, there were no data definitions, there were no avenues for sharing information -- there was nothing excerpt the desire to make this a better planet by reducing the risk of infection. People who cared about doing that figured out how to stay in touch with each other, how to build a profession. I think our persistence has been key, but it hasn't been without big challenges because there are so many competing interests in healthcare. That has made it an uphill climb to move forward on reducing infection.”
Dickey points to the fact that APIC didn’t start as an IP-exclusive organization. “One thing that was surprising to me when we were talking with some of the original founders and also looking at the original first newsletter for APIC, was that it wasn’t intended to solely be an association for professionals in infection control; it wasn't specifically for what we now call infection prevention, in that it was more physicians, nurses and housekeepers, and anybody who was a professional and saw it within their scope of practice to reduce the risk of infection. I love that, because we have seen the emergence of a profession that is specifically aimed solely at preventing infections but the whole idea of also having a professional association where you could collaborate with other people who have that as part of what's in their sphere of influence is lovely.”
A former APIC president, Connie Steed, MSN, RN, CIC, FAPIC, is a veteran IP recently retired from a large healthcare enterprise who has worked in the field since 1978 and recalls the evolution of the profession. “Back in those golden days we were called infection control nurses; now the focus is on prevention and with that has come process change as we address infections caused by emerging antibiotic-resistant organisms.”