Infection preventionists (IPs) juggle multiple responsibilities as they deal with new regulations and ongoing workplace challenges. Once a part-time or shared position with other roles such as employee health or education, IPs are now tasked with increased visibility and accountability to meet the multitude of challenges affiliated with healthcare-associated infections (HAIs). IPs have become integral players in programs that involve:
- Patient safety and infection prevention improvement initiatives
- Pharmacy collaborations to decrease unnecessary antibiotic prescribing as part of antimicrobial stewardship
- Strategies for addressing new emerging pathogens and possible future pandemics
- Incorporation of electronic infection prevention surveillance technology
- Compliance with federal and state regulations along with value-based purchasing initiatives
Infection preventionists must confidently face a constantly changing healthcare landscape as they consider these 5 key challenges:
1. Increased reporting requirements
IPs must be knowledgeable about the various agencies and regulatory entities that oversee/publish standards for reporting of HAIs. These bodies include the National Healthcare Safety Network (NHSN) as part of the Centers for Disease Control (CDC), the Centers for Medicare and Medicaid Services (CMS), and state and federal health agencies. Also, passage of the federal Affordable Care Act (ACA) has resulted in the promulgation of many new regulations governing infection prevention. In 2015, the CMS's Hospital-Acquired Condition (HAC) Reduction Program, created under ACA, will require expansion of reporting of certain HAIs from acute care hospitals' intensive care units to include patients on medical, surgical and medical-surgical floors. Regulatory compliance and reporting may be the top challenge faced by IPs.
2. Limited time to accomplish multiple goals
With IP increased data reporting responsibilities, IPs are faced with less time to devote to other initiatives such as patient safety programs to increase hand hygiene, decrease antibiotic resistance, and reduce transmission of multi-drug resistant organisms. How can IPs improve their efficiency? They can collaborate with different departments to improve patient safety at multiple points of care. Examples of this include collaboration with the pharmacy team to monitor antibiotic usage, working with nursing to monitor isolation and hand hygiene practices, or involving Environmental Services to ensure proper surface disinfection of patient care areas.
3. Infection surveillance inefficiencies
Many hospitals still use manual infection surveillance methods where the IP may spend hours sifting through paper culture reports to identify potential HAIs or patient isolation interventions. The reports are often delayed, limiting opportunities for effective HAI mediation. Many hospitals are turning to implement automated infection surveillance technology that can facilitate patient data collection and analysis in real-time to increase surveillance efficiency.
4. Increased scrutiny on hospitals due to public visibility of HAIs
Hospitals are experiencing increased public visibility, due in part to media-enhanced attention regarding the impact that HAIs from multi-drug resistant organisms (MDROs) or C. difficile have on patient safety and healthcare economics. Public scrutiny will increase with new reporting requirements in place, so IPs must play a central role in assuring that healthcare organization's administration is making a long-term commitment to infection prevention and control goals.
5. Responsibility without budgetary authority
Tight budgets lead to difficult financial decisions in today's healthcare environment. This is a big challenge for IPs who are tasked with additional responsibilities but may lack the authority to approve better systems for infection prevention and surveillance. The Association for Professionals in Infection Control and Epidemiology (APIC)1 suggests IPs learn to make the business case for increasing infection prevention and control resources. IPs enhance their personal business and presentation skills and use data to calculate the true costs of HAIs for a healthcare organization.
1. Hanchett, Marilyn, RN, MA, CPHQ, CIC. Moving the Profession Forward. Prevention Strategies. 2012, Summer."