Although strict adherence with infection control practices is needed to curb the transmission of SARS-CoV-2 in nursing centers, most facilities only have one staff member with specialized infection control training, the infection preventionist. In early 2021, the Connecticut Department of Public Health asked a team of Q&I researchers to create and pilot test a program for nursing homes to extend infection preventionists’ expertise throughout their facilities.
We designed an infection control peer coaching program, Infection Control Amplification in Nursing centers (ICAN). ICAN involves (1) designating peer coaches to provide in the moment corrections and encouragement to coworkers and (2) creating a data feedback loop that enables the infection preventionist to direct peer coaches based on identified needs.
Q&I conducted an eight-week pilot with seven Connecticut nursing centers in April and May 2021, to assess program feasibility while eliciting feedback to improve ICAN. Overall, infection preventionists at the seven sites felt that the program was valuable and highly-aligned with their needs, although they also reported barriers to implementing ICAN -- many resulting from operating short-staffed due to the pandemic and managing outbreaks.
Based on our pilot findings, we made a series of changes to the program including incorporating a team-based quality improvement approach and offering greater flexibility for how to implement coaching and communicate with the peer coaches. These changes were intended to embed the program in the nursing center and to facilitate infection preventionists' implementation of ICAN. The resulting program is publicly-available for nursing centers to use and adapt, even as we continue to test and refine it.
We are making ICAN immediately and widely accessible to nursing centers, as this program addresses an important, time-sensitive need during the ongoing pandemic. The American Health Care Association/National Center for Assisted Living and others are already incorporating ICAN into quality programs. As one ICAN participant shared: “It really did give us the lift we needed during the long stretch of the pandemic and all the residual impacts. We really did come together and unite. I think it created a sense of safety and even peace.”
To learn more about implementing ICAN at your center, please visit our website: sites.brown.edu/ican