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Preparing Before it Happens, Reacting When it Does

January 2013

As any nurse will attest, walking into work can bring the unexpected. Nurses are trained for years by professors and colleagues to think and react quickly to help care for a patient. However, there is another set of nurses – those in infection prevention and control – who research, learn and provide guidance to others to ensure that not only their patients are safe from other diseases while being treated, but that nurses themselves are protected.

A Certified Infection Control (CIC) nurse, also known as an infection prevention nurse or infection preventionist, specializes in identifying, controlling and preventing outbreaks of infection in healthcare settings and in the larger community. While this description may seem very straight-forward, their day-to-day activities, knowledge and skills are exceptionally advanced and complex.

“Depending on the complexity of the situation, an infection control nurse could collaborate with a physician, pharmacist, microbiologist, materials manager or environmental services professional, all to help address issues relevant to the care of just one patient,” said Ruth Carrico, Ph.D., RN, FSHEA, CIC, Associate Professor at the University of Louisville School of Medicine in Louisville, Ky. “This specialty is very team focused. We are trying to prevent and prepare, and with that, you have to seek guidance from your peers in all areas of healthcare and even outside those perimeters into larger society-focused professions, such as engineering, computer sciences and public health.”

According to Carrico, the infection prevention and control nursing specialty wasn’t always this complex. Infection prevention has become increasingly broader with time – a mere reflection of the advancement of healthcare, the evolution of infectious diseases and the challenges that accompany new technologies.

“Forty years ago, nurses and other healthcare professionals were just reacting to situations. Then the notion of taking a programmatic approach to infection control was conceptualized and the focus moved toward the gathering of information concerning risk. The importance of research led to medical and healthcare decisions based on this information – the scientific evidence,” said Carrico.

As healthcare continued to advance, the importance of disease prevention and rapid recognition of infection and infection risk became the standard of practice. Scientists and clinicians continued to learn that specific diseases and microorganisms are multifaceted and can affect any patient in any setting – not just the hospital. Now, to be proactive against diseases and infections, board certified infection preventionists (designated as CIC) and other prevention-focused healthcare professionals are constantly researching to help develop evidence-based practices.

As one of the most crucial infrastructures of healthcare, CIC nurses carry a huge responsibility to keep patients and the larger public safe. When asked about one of the most difficult situations she’s had to endure as a CIC nurse, Carrico reflected on her experience during the Severe Acute Respiratory Syndrome (SARS) outbreak of 2003.

“We were notified of a patient that was potentially infected and were immediately asking ourselves questions of safety and logistics, such as, how do we get this patient into the building? How do we coordinate all of the outside communications? How do we keep our nursing staff safe? Are they confident in being able to treat this patient while being able to protect themselves? These were just a few of the questions that my team had to think about, but we trusted the research and our strong skill sets to help us make difficult, yet critical, decisions,” said Carrico.

Despite the complicated work and challenges that CIC nurses face, and the constant on-call status, many find the specialty to be rewarding and fulfilling. “There are many nurses interested in this specialty that come and shadow me, and the first thing they say is, ‘I had no idea that all of this went on.’ I agree and let them know that there isn’t a single day that goes by that I’m not learning or doing something different from the day before,” said Carrico.

Carrico advises any student, new nurse or current nurse interested in the infection control nursing specialty to obtain a solid background of clinical experience and focus on sharpening their critical thinking skills. “A vital part of my job is to understand how diseases are transmitted and the role of microorganisms, and it’s important to be able to translate that knowledge into practice. We continuously look for new and better ways to provide safe and effective care for all patients.”

The Certification Board of Infection Control and Epidemiology (CBIC) offers certification for infection control nurses who have actively practiced in the specialty for two years or more. Initial certification is good for five years and successful completion of recertification exams is required at five-year intervals.

For more information about the career of an infection control nurse, visit

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