Purpose: While significant progress has been made in infectious disease (ID) prevention and treatment, much work remains to keep patients safe and free from harm. For example, in the US, healthcare-associated infections (HAI) remain a major patient safety problem. On any given day, one in 25 hospitalized patients acquires at least one HAI, including pneumonia, gastrointestinal illness such as
Clostridium difficile infection, infections of the urinary tract, bloodstream or surgical site.
1 This translates to approximately 722,000 HAIs and 75,000 deaths annually.
1 The majority of HAIs are preventable with the systematic implementation and sustained use of evidence-based infection prevention and control (IPC) practices.
2 Additionally, antibiotic resistance poses an escalating threat to public health worldwide.
3 In response, the American Nurses Association with the Centers for Disease Control and Prevention released a White Paper outlining how nurses can become more engaged and take a leadership role to enhance antibiotic stewardship efforts.
4 Given the morbidity and mortality associated with HAIs, the rapid rise of antibiotic resistance, and the resurgence of IDs such as Ebola virus and other high-threat pathogens, it is essential that nursing students graduate from their programs, with a deep understanding of the infection concept, and the ability to apply their knowledge and skills regardless of complexity of patient or geographic location.
5 In fact, a recent national study affirms this conclusion indicating that infection is a critical concepts to include in concept-based curriculum (CBC).
6 As a result, we decided to evaluated our baccalaureate CBC, launched in 2016, for infection concept integration.
Methods: We began by reviewing the overarching curriculum concept map for the concept of infection, followed by examination of each course syllabi (n=22) and course content outline for topics related to infection and IPC. Next, course faculty were interviewed (n=10) to determine if additional content, not evident from syllabi or outlines, was taught.
Results: We found the absence of infection in the overarching curriculum concept map and inconsistencies between the curriculum concept map and course content outlines. Infection and IPC related content was limited and usually included under the concept of immunity. Exemplars included hand hygiene, HAI, HIV, and cellulitis. Faculty interviews revealed content taught not appearing in course syllabi or content outline, including principles of sterility and isolation precautions.
Conclusions: The results of this faculty-driven infection concept integration review, indicates we may not be preparing students sufficiently for contemporary IPC practice. This prompted our CBC evaluation team to revise the curriculum and suggest building increasingly complex exemplars and simulation activities to reinforce critical IPC knowledge and practices. Nurses entering the workforce must have the requisite knowledge, skills, and attitudes to recognize, prevent, and manage infection in individuals and populations, as well as be prepared to respond collaboratively to local, regional, and global IPC challenges. The concept of infection and the related IPC practices should be an integral component of all undergraduate nursing programs worldwide.
