Infection Prevention and Control in a COVID-19 World

Many people have started speaking at least part of Elsie Truter’s lingo since the advent of Covid-19. 

“Everyone knows what PPE is now,” says this Toi Ohomai academic staff member whose working world is focused on Infection Prevention and Control.  

Elsie and fellow Toi Ohomai tutor Francie Morgan, run New Zealand’s only postgraduate tertiary courses in infection prevention and control. The Toi Ohomai courses (at certificate, diploma, and masters’ levels) are likely to become increasingly popular, Elsie suspects, thanks to Covid-19. 

“We noticed a good peak in interest in the second semester of 2020. What Covid uncovered for many people was unpreparedness and the need for experienced staff to deal with the impact of the pandemic. This was certainly evident in long-term care facilities and hospitals too, she says, where she believes far more trained people were needed on the ground to deal with hand hygiene and the correct use of PPE gear. 

“People were scrambling and the trained infection control experts were exhausted by the huge demands placed on them. Nobody had adequate numbers of trained staff, which was both remarkable and scary.  

“It is incredibly fortunate that our government took the steps it did in ensuring a strict and early lockdown. It has given us time to prepare and address the shortcomings this pandemic has exposed.” 

Elsie’s hopeful infection control will gain a higher priority now for district health boards and long-term care facilities.  

“It is important to raise the profile of this field. We need to acknowledge the requirement for a good team in every hospital as this is something that has to be future proofed. We have to have people on the ground with a knowledge of infection control in preparedness for future outbreaks. This won’t be the last pandemic for sure.”  

When not working in her contractor position as course co-ordinator at Toi Ohomai, Elsie works at the Southern Cross Hospital in Rotorua. She is a registered nurse, midwife and a postgraduate surgically-trained perioperative and infection control nurse. She holds a masters’ degree in medical ancient history. Elsie is a member of the Infection Prevention and Control, and Anti-Microbial Steward committees at Lakes District Health Board. She is chair of the Infection Control College Midland branch. 

Elsie, who spent her formative years in The Netherlands and South Africa, has been in New Zealand since 1987 and began her Toi Ohomai association in 1995. As well as working within the infection control field, her main job initially was as a Bachelor of Nursing lecturer in anatomy, physiology and microbiology. She stopped lecturing in that area in 2017. 

Working within the infection prevention field at Toi Ohomai is especially interesting, she says. 

“It covers so much. You have to have a very wide knowledge base to become an efficient infection control nurse. As a specialty within a medical environment, this can involve anything from kitchen processes, waste management streams, antibiotic use, an understanding of epidemiology and microbiology, and the workings of operating theatres and sterilisation departments. 

“Francie (who has more than 35 years’ experience in this field) and I are madly keen on what we do. It’s a fascinating, versatile field that has its fingers in so many aspects of medical and surgical care.” 

The postgraduate courses (called Applied Professional Studies) on offer within Elsie and Francie’s faculty have been running for five years with students taught in a blended way. The majority of classes are taught online and are very tutor directed, plus there’s an on-campus requirement each semester. 

Elsie’s happy to announce some changes are afoot in 2021. Up until now, only two grad certificate papers were offered per semester. The intention for 2021 is that all four of the required papers be offered in the one semester to better suit full-time students. Those keen to pursue studies toward a grad certificate in this field must be either working as an infection control nurse, or working in close proximity to an infection control nurse. With the grad certificate achieved in one semester, interested students can then use the second to achieve the required additional paper to gain a diploma. The length of time taken to complete the masters’ course varies according to thesis requirements but is typically a full year. 

The students committing to postgraduate studies in this field are from throughout the country and most have undergraduate nursing degrees. It’s usual for between seven and 11 to start postgraduate study in this faculty each year. Some may have other masters’ degrees already, Elsie says, but want a specialty paper, so may opt to go to postgraduate diploma level. The postgraduate studies are excellent for those aiming for an expert position and needing theoretical and educational learnings.  

“People throughout New Zealand are becoming increasingly aware of what Toi Ohomai offers in terms of infection control learning. We have progressed courses to a level that people can study to become managers in this area and this has created great interest,” Elsie explains. 

The postgraduate courses have been written by infection control nurses for infection control nurses. Topics include critical reflective practice, microbiology, and responses to infection, healthcare epidemiology, infection prevention control in practice.  

Those not interested in postgraduate study can achieve certificates or diplomas in Infection Risk Management. This is more public health, rather than hospital orientated and a nursing background is not required.                                                                                                                                                                                                      

Elsie adds that ACC now promotes education related to infection control and offers scholarships for those studying infection control.