Interview with A.U. Bankaitis, Ph.D., Co-author of Infection Control for Speech Pathology, Oaktree Products, Inc.
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Linda: Hi A.U. Tell the readers a bit about your background and how you came to take such an interest in the prevention of infectious diseases.A.U.: My educational background is in the area of Audiology and Speech-Language Pathology. I earned a masters degree in audiology from Cleveland Sate Univers
Linda: Hi A.U. Tell the readers a bit about your background and how you came to take such an interest in the prevention of infectious diseases.
A.U.: My educational background is in the area of Audiology and Speech-Language Pathology. I earned a masters degree in audiology from Cleveland Sate University in 1990 and immediately moved to Cincinnati to pursue my doctorate at the University of Cincinnati while simultaneously completing my CFY at the University of Cincinnati Medical Center. My coursework mainly focused on neuroscience as well as statistics & research design.
My involvement in infection control was somewhat of an accident; I happened to be in the right place at the right time. Within the first year of my doctoral studies, a relationship was established with the Infectious Disease Center at the University of Cincinnati to study the effects of varying degrees of HIV on the auditory system. Given my research focus, colleagues and co-workers started inquiring about infection control. In the absence of readily accessible information, I educated myself in the area of infection control with specific application to audiology and speech-language pathology and started sharing that knowledge with my colleagues. Over the past 15 years, I have worked in a variety of clinical, academic, and corporate settings; however, the one constant has always been infection control. I haven't yet stopped talking to audiologists and speech-language pathologists about it.
Linda: Tell us what you mean by the term infection control.
A.U.: Infection control refers to the conscious management of the clinical environment for the specific purposes of minimizing the potential spread of disease.
Linda: Why should infection control be of interest to speech-pathologists? I assume we are not talking about prevention of the common cold.
A.U.: Standard practices of speech-language pathology require integration of infection control procedures for several reasons.
A.U.: HIV was the catalyst of change in infection control; upon its discovery during the 1980s, concern for cross-contamination resulted in OSHA and other regulatory bodies to enact regulations for providing health care employers and workers with guidelines on how to reduce the risk of exposure to infection agents. Having said that, it is important to recognize that infection control is NOT about protecting our patients or ourselves from the threat of HIV/AIDS. Rather, infection control begins in the mindset that every patient is assumed to be a potential carrier of and/or susceptible host for an infectious disease, even something as presumably innocuous as staphylococcus.
Linda: Why control for infections? Doesn't allowing the immune system to fight off infections help to strengthen the system?
A.U.: The answer is very simple; because it is the law. The effectiveness of an individual's immune system has no bearing on whether or not infection control procedures should be applied in the clinical setting. Infection control is regarded as standard care for every patient. Speech-language pathologists are legally and ethically responsible for minimizing the potential spread of disease in the clinical environment.
Linda: Then, I assume you recommend specific steps that SLPs should follow to control for infection agents?
A.U.: In response to the AIDS epidemic, the Centers for Disease Control and Prevention (CDC) issued a number of recommendations and guidelines for minimizing cross-infection of blood-borne diseases to health care workers known as universal or standard precautions. These precautions were originally intended to protect health care workers from blood although the precautions have been expanded to include all potentially infectious bodily substances.
Beyond applying universal or standard precautions to clinical operations, as outlined by OSHA, a written infection control plan with profession-specific work practice controls is required. The concept of work practice control is probably the most misunderstood element of the written infection control plan. While health care entities will certainly have a general infection control policy filed away, work practice controls are written procedures that specifically outline, for example, how endoscopic or tracheal suctioning procedures will be performed by the speech-language pathologist for purposes of minimizing the spread of disease. These are procedures to be written and implemented by the health care practitioners directly involved in the provision of that service.
Linda: Where can SLPs get more information on this topic?
A.U.: The book Infection Control for Speech-Language Pathology by Bankaitis, Kemp, Krival and Bandaranayake (2005) is a comprehensive resource written for speech-language pathologists. The 196-page book offers speech language pathologists and graduate students everything needed to implement an infection control plan in the clinic, including an in-depth overview of infection control, the immune system, microbiology, infectious diseases, HIV/AIDS, and regulatory agencies. Separate chapters dedicated to infection control for common speech-language pathology procedures, feeding/swallowing assessments, and examination of resonance and voice disorders provide invaluable insight and practical guidelines for effective program implementation. A glossary and complete infection control plan template are also provided.
Linda: To order copies of this book, contact Oaktree Products, Inc. toll-free at (800) 347-1960. For additional information, feel free to contact A.U. Bankaitis personally at Oaktree Products or via e-mail at au@oaktreeproducts.com
Linda: A.U., thanks so much for enlightening us about our responsibilty to control infection and how we can go about doing that.
A.U.: My educational background is in the area of Audiology and Speech-Language Pathology. I earned a masters degree in audiology from Cleveland Sate University in 1990 and immediately moved to Cincinnati to pursue my doctorate at the University of Cincinnati while simultaneously completing my CFY at the University of Cincinnati Medical Center. My coursework mainly focused on neuroscience as well as statistics & research design. My involvement in infection control was somewhat of an accident; I happened to be in the right place at the right time. Within the first year of my doctoral studies, a relationship was established with the Infectious Disease Center at the University of Cincinnati to study the effects of varying degrees of HIV on the auditory system. Given my research focus, colleagues and co-workers started inquiring about infection control. In the absence of readily accessible information, I educated myself in the area of infection control with specific application to audiology and speech-language pathology and started sharing that knowledge with my colleagues. Over the past 15 years, I have worked in a variety of clinical, academic, and corporate settings; however, the one constant has always been infection control. I haven't yet stopped talking to audiologists and speech-language pathologists about it.
Linda: Tell us what you mean by the term infection control.
A.U.: Infection control refers to the conscious management of the clinical environment for the specific purposes of minimizing the potential spread of disease.
Linda: Why should infection control be of interest to speech-pathologists? I assume we are not talking about prevention of the common cold.
A.U.: Standard practices of speech-language pathology require integration of infection control procedures for several reasons.
- First, infection control is a federally mandated standard overseen by the Occupational Safety and Health Administration (OSHA). Health care settings (and their employees) are required to comply with current regulations.
- Second, the scope of speech-language pathology inherently exposes clinicians to bodily fluids.
- Third, the nature of the profession involves a significant degree of direct and indirect contact with multiple patients and multiple reusable objects in the vicinity of natural body orifices (e.g., eyes, ears, nose, mouth). These factors increase the likelihood of disease transmission and necessary precautions must be applied to eliminate or minimize its occurrence.
- Furthermore, speech-language pathologists provide services to a wide range of immuno-compromised patients who are susceptible to opportunistic infections. A proactive strategy must be implemented and followed to minimize or reduce the inadvertent spread of disease.
- Finally, the medical and audiology literature have clearly shown that instruments (e.g., stethoscopes) and other medical devices (e.g., hearing instruments) are contaminated with ubiquitous, as well as other virulent microorganisms, that under the right circumstances can cause serious, even life-threatening diseases in susceptible patient populations (e.g., geriatric or pediatric patients, patients from poor socioeconomic backgrounds, patients with underlying disease such as diabetes, patients with history of chemotherapy or pharmacological regimens that compromise immunity, etc.).
A.U.: HIV was the catalyst of change in infection control; upon its discovery during the 1980s, concern for cross-contamination resulted in OSHA and other regulatory bodies to enact regulations for providing health care employers and workers with guidelines on how to reduce the risk of exposure to infection agents. Having said that, it is important to recognize that infection control is NOT about protecting our patients or ourselves from the threat of HIV/AIDS. Rather, infection control begins in the mindset that every patient is assumed to be a potential carrier of and/or susceptible host for an infectious disease, even something as presumably innocuous as staphylococcus.
Linda: Why control for infections? Doesn't allowing the immune system to fight off infections help to strengthen the system?
A.U.: The answer is very simple; because it is the law. The effectiveness of an individual's immune system has no bearing on whether or not infection control procedures should be applied in the clinical setting. Infection control is regarded as standard care for every patient. Speech-language pathologists are legally and ethically responsible for minimizing the potential spread of disease in the clinical environment.
Linda: Then, I assume you recommend specific steps that SLPs should follow to control for infection agents?
A.U.: In response to the AIDS epidemic, the Centers for Disease Control and Prevention (CDC) issued a number of recommendations and guidelines for minimizing cross-infection of blood-borne diseases to health care workers known as universal or standard precautions. These precautions were originally intended to protect health care workers from blood although the precautions have been expanded to include all potentially infectious bodily substances.
Beyond applying universal or standard precautions to clinical operations, as outlined by OSHA, a written infection control plan with profession-specific work practice controls is required. The concept of work practice control is probably the most misunderstood element of the written infection control plan. While health care entities will certainly have a general infection control policy filed away, work practice controls are written procedures that specifically outline, for example, how endoscopic or tracheal suctioning procedures will be performed by the speech-language pathologist for purposes of minimizing the spread of disease. These are procedures to be written and implemented by the health care practitioners directly involved in the provision of that service.
Linda: Where can SLPs get more information on this topic?
A.U.: The book Infection Control for Speech-Language Pathology by Bankaitis, Kemp, Krival and Bandaranayake (2005) is a comprehensive resource written for speech-language pathologists. The 196-page book offers speech language pathologists and graduate students everything needed to implement an infection control plan in the clinic, including an in-depth overview of infection control, the immune system, microbiology, infectious diseases, HIV/AIDS, and regulatory agencies. Separate chapters dedicated to infection control for common speech-language pathology procedures, feeding/swallowing assessments, and examination of resonance and voice disorders provide invaluable insight and practical guidelines for effective program implementation. A glossary and complete infection control plan template are also provided. Linda: To order copies of this book, contact Oaktree Products, Inc. toll-free at (800) 347-1960. For additional information, feel free to contact A.U. Bankaitis personally at Oaktree Products or via e-mail at au@oaktreeproducts.com
Linda: A.U., thanks so much for enlightening us about our responsibilty to control infection and how we can go about doing that.