Fifty years of evolution in infection prevention and control programs have involved significant accomplishments related to clinical practices , methodologies , and technology . However , regulatory mandates , and resource and research limitations , coupled with emerging infection threats such as the COVID-19 pandemic , present considerable challenges for infection preventionists .” — Robert Garcia ,
BS , MT ( ASCP )
long-term care facilities , physician practices , home healthcare , etc . That ’ s a trajectory that has really impacted infection prevention and control , and we ’ re very much in demand .”
While the terminology has evolved to fit the times and the institutional political mood , at its core , the practice of infection prevention and control encompasses a set of tenets , including leadership support ; education and training of healthcare personnel on infection prevention principles ; patient , family and caregiver education ; performance monitoring and feedback ; adherence to standard precautions and transmission‐based precautions ; and occupational health . These core infection prevention and control practices should be implemented in all healthcare settings across the continuum of care .
Having a robust IP & C program is more important than ever before , and as Garcia , et al . ( 2022 ) observe , “ Fifty years of evolution in infection prevention and control programs have involved significant accomplishments related to clinical practices , methodologies , and technology . However , regulatory mandates , and resource and research limitations , coupled with emerging infection threats such as the COVID-19 pandemic , present considerable challenges for infection preventionists .”
As Garcia , et al . ( 2022 ) note further , “ Infection prevention programs in healthcare facilities nationwide have enhanced the culture of safety through modifications in each organization ’ s systems of care by assessing efficacy , and revising , standardizing , and monitoring clinical and ancillary practices . Coordinated efforts at reducing HAIs have been determined to be effective to varying degrees when IP & C programs are provided with adequate resources and supported by the implementation of evidence-based strategies . Multi-faceted HAI prevention programs have been proven to be cost-effective , a finding of vital importance in the present landscape of healthcare reimbursement and therefore in the overall financial health of the institution . IP & C efforts have been facilitated by application of such fundamental tools as core components , competency models , and implementation science which assist infection preventionists ( IPs ) to bridge gaps between organizational barriers to change and successful outcomes .”
A comprehensive infection control program consists of numerous components including evidence‐based written policies and procedures , training and education , healthcare personnel safety ; and surveillance and disease reporting ; as well as conducting infection control program assessments to identify program strengths and weaknesses and which can be utilized for staff education and improved patient outcomes . It ’ s a tall order , and one that evolves in the face of outbreaks , pandemics , and other crises .
In their AJIC paper , Garcia , et al . ( 2022 ) documents the current state of infection prevention and control , and outlines guidance and recommendations in 14 key areas that establish a roadmap for future implementation of these interventions . Robert Garcia , BS , MT ( ASCP ), infection preventionist at Stony Brook University Medical Center in New York , says he collaborated with experienced IPs , epidemiologists , and other content experts to address the most significant issues currently affecting IP programs , with an emphasis on “ implementation of innovative , cost-effective , and evidence-based interventions , engaging healthcare leaders and experts in clinical care in proven prevention measures , holding staff accountable , and adopting high reliability principles .”
Among the key challenges and recommendations for change cited in their paper , Garcia , et al . ( 2022 ) emphasize the importance of IP & C program standardization . They point to the 2015 APIC Mega Report which provides a look at the average percent of time spent on key areas but does not address the variability from one hospital to another . “ Although reporting structure is key to the success of an IP program , there is currently wide variation regarding hierarchical reporting with some programs reporting to quality departments , some to nursing , some to patient safety , and a few directly to the C -suite or executive level ,” the authors write . “… Infection prevention department staffing is also lacking standardization . A recent peer-reviewed study concludes that the actual IP staffing level in U . S . hospitals is anywhere between 31 percent to 66 percent above the current outdated benchmark of 0.5-1.0 IP per 100 occupied beds . Research is needed to define the ideal for each of these essential program components , which would together provide a reliable design for a best practice IP & C program .”
Regarding IP & C program standardization Garcia and colleagues ( 2022 ) make key recommendations for change :
• Based on outcomes based scientific research ( e . g ., HAI rates , process compliance , patient satisfaction ), establish a standard template for IP programs to support the replication of best practices , avoid errors , and optimize processes
• Conduct research focusing on determining IPs time allocation , considering variability between healthcare facilities
• Conduct research into IP & C program reporting structure
• Establish a certification process for physicians in IP programs
• Conduct research to determine ideal IP staffing levels based on essential program components
“ One of the top priorities for APIC is conducting and publishing research on what a strong , effective infection prevention program looks like ,” Dickey says . “ What should the resourcing look like ? What is the best staffing ratio in different settings , as