Behind the Scenes at the Brigham: Infection Preventionists
Whether responding to a pandemic, collaborating to enhance safety protocols or investigating the source of a hospital-acquired infection, the Brigham’s dedicated team of infection preventionists in Infection Control uses their specialized and diverse expertise to help keep patients, visitors and staff healthy and safe.
Infection preventionists, whose backgrounds can range from nurses to epidemiologists to microbiologists, look for patterns of infection within a facility. From monitoring medical devices for cleanliness to ensuring isolation protocols are followed, the team is passionate about proactively preventing the spread of infection through evidence-based best practices.
But even in the most cautious environments, the world of microorganisms — which includes tiny germs such as viruses, bacteria, yeasts and molds — can still find its way in, sometimes in unexpected ways. When that occurs, the Brigham’s seven super-sleuthing infection preventionists are on the case, looking for clues and advising colleagues on the best ways to protect patients, families and staff.
“We do a lot of detective work to gather information, find connections and piece together what’s happening,” said Robert Tucker, MPH, CIC, FAPIC, Infection Control manager and lead infection preventionist at the Brigham.
Each of the Brigham’s infection preventionists specialize in a different area of the hospital, with one team member always on call to ensure safety standards are continually upheld. “We are responsible for monitoring 200 locations,” Tucker said. “While most of the activity takes place at the main campus, there’s a lot that happens all around.”
In addition, the team often collaborates closely with Dana-Farber Cancer Institute’s Infection Control team to address the unique concerns of oncology patients in the hospital.
Elizabeth Blaeser, MPH, CIC, is the infection preventionist responsible for overseeing the Brigham’s maternal and neonatal intensive care units. Her work involves managing infection control between mothers and their infants, which can often be more complex than other inpatient units.
“The mom-baby dyad presents a lot of interesting issues that you don’t typically see when you’re dealing with just one patient,” she said. “If the mom has MRSA (methicillin-resistant staphylococcus aureus), do we separate them and put the baby in isolation? Or do we assume the baby has MRSA and keep them together, knowing how important that bonding time can be to the family?”
In addition to responding to real-time events, Blaeser and other infection preventionists also frequently review past cases to identify opportunities to improve prevention strategies and reinforce protocols.
“It gives us fuel to drive home the importance of basic infection control practices,” Blaeser said.
A Dedicated Team
Although the team is small, their collaborative approach and shared expertise make the scale of their impact far greater than their size would suggest, Tucker explained.
“Everyone does a little bit of everything,” he said. “It’s a great way to grow their skills so everyone is knowledgeable in many areas and we can share best practices.”
Pamela Linzer, RN, PhD, NEA-BC, often works with the team in her role as associate chief nursing officer of Medicine and the Center of Nursing Excellence. She praised the dedicated assistance the infection preventionists provide to nurses and their patients.
“They do their best to understand the full scope of the issue before trying to solve it,” Linzer said. “They’re problem-solvers and they’re willing to listen to all aspects. They’re also very communicative and always make sure that our nursing community is part of the solution with them.”
Linzer recalled instances where the team used different approaches to educate nurses about best practices. For example, they brought in a guest speaker from California who discussed why patients should be bathed in a certain way to prevent infections.
The team also plays a pivotal role in employee-facing initiatives, such as For All the Lives We Touch, an ongoing campaign to reinforce hand hygiene across the organization.
“We look for systematic ways to make these processes more reliable and support staff while they are caring for our patients and their families,” Tucker explained.
A New Focus
With the onset of the COVID-19 pandemic, Tucker and Blaeser noted a major shift in their workload that has somewhat persisted three years later.
“I’d say 80 percent of questions and pages we get from staff now are about COVID,” Tucker said.
At the beginning of the pandemic, the infection preventionists immediately noticed an uptick in calls for assistance. Their pager surged far above the pre-COVID average of five pages per day.
“That went up to between 50 and 100 pages in a day once COVID started,” Tucker said.
Blaeser noted the team’s immense contributions during that time to extensive contact tracing, which involved identifying people who tested positive for COVID-19 and every care staff member and patient they came in contact with.
“I don’t think people realize how much work would go into every single COVID case,” she said. “There was a long time where every single person in the Brigham — ambulatory or inpatient, as well as employees who were diagnosed with COVID — had to be investigated by our team.”
Despite the challenges, infection prevention is a job that both Tucker and Blaeser said they deeply enjoy.
“We’re working with other people in the hospital to improve practices,” Blaeser said. “It’s intellectually stimulating, and we’re making a difference.”
To learn more about the Infection Control team, visit their page on BWH – Vitals (access restricted to internal network and VPN users).
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