Development and Assessment of Surveillance Competency Among Infection Preventionists

Session Description: Effective infection prevention and quality programs require consistent and accurate application of the National Healthcare Safety Network surveillance definitions by Infection Preventionists. Precise coding of health care acquired infections is critical to identifying epidemiologically significant events, guiding data-driven improvements, and compliance with state and federal mandated reporting requirements. Errors in coding healthcare acquired infections decreases data integrity and can result in missed opportunities to improve patient outcomes along with reduced reimbursement for hospitals.
While public surveillance training modules are available for infection preventionists, a systemized validation of the surveillance competency is not widely available. In this presentation, we describe how item discrimination and item analysis were used to develop a validated test bank of surveillance case studies for inter-rater reliability. Case studies were distributed annually over a five-year period to evaluate the competency among a group of one hundred and ten infection preventionists varying in experience from novice to expert level over a five-year period. The first-time pass rate was thirty-three percent among all participants. Infection preventionists who were certified and reported performing surveillance for at least nine hours per week were more likely to pass on the first attempt.
Each case study was categorized by subject matter which allowed for identification of topic-specific strengths and weaknesses for each participant. Supplemental surveillance modules to enhance education were developed, and participants were assigned to intervention groups based on inter-rater reliability performance. Modules included required attendance of preceptor lead webinars and group discussions that reviewed surveillance definition application. Post-intervention, inter-rater reliability scores improved for ninety percent of the participants. Given the first-time pass rate for the study group was below optimal for infection preventionists of all experience levels, it suggests additional surveillance education and competency verification could improve inter-rater reliability for individuals responsible for coding healthcare acquired infections.