Thanks to shifting care models and an aging population, infection prevention and control (IPC) leaders will need to rethink and refresh their approach to risk assessment in the future.
The specifics of your IPC risk assessment — a detailed review of potential risk factors for infection related to the care and services you provide — will vary depending on your goals and risk profile. Focusing on SMART (Specific, Measurable, Actionable, Realistic, Timely) elements will help ensure a solid foundation as you customize your risk assessment and infection control plan.
1. Specific: Create a detailed list of infection risks and challenges
From outbreaks of specific pathogens to your most common services, your IPC risk assessment should be shaped by your unique environment and goals. Here are a few factors to consider.
Geographic location
Infection risk can vary significantly by region. For example, Oregon had its first outbreak of three cases of the drug-resistant fungus Candida auris in late 2021; by that time, California, Illinois, New York and Florida had all had over 100 cases in a one-year period, the CDC reports.
Population served and surrounding community
Patient demographics will also shape your risk assessment. Older patients, for example, have more contact with long-term care facilities where respiratory tract and gastrointestinal infections are common, notes research from Epidemiology and Infection.
Employee management and staff education
All staff must be updated on the latest infection control policies and current risks to effectively support your program.
Environment of care and cleaning procedures
Your physical environment, plus your cleaning, disinfection, and sterilization practices, will also shape your IPC program. For example, many newer facilities incorporate evidence-based design to support and enhance infection control outcomes. Additionally, your level of investment in practices like antimicrobial stewardship will have a direct impact on your risk assessment.
Emergency preparedness
The COVID-19 pandemic has significantly impacted healthcare systems worldwide, leading to notable changes in the prevalence of certain infections in hospitals. A combination of factors including changes in healthcare practices, increased use of medical interventions, and overwhelmed healthcare infrastructures contributed to these trends for certain infections that appeared more frequently post-pandemic including multi-resistant bacterial, hospital-acquired, C. difficile infections.
Risk of infections
Depending on your service lines, population mix, and supplies used, your overall and patient-specific risk of infection will change. These risks can include:
- Procedure-associated risks
- Device-associated risks
- Emerging or multidrug-resistant organisms
- Enteric diseases
- Respiratory diseases
2. Measurable: Make use of data
The data you collect from clinical surveillance is one of the most powerful tools you have in infection control risk assessment. For example, if your antibiogram reveals increased resistance patterns for commonly seen organisms, your assessment should address this discovery.
One highly useful tool in assessing program effectiveness is the CDC’s Targeted Assessment for Prevention Strategy (TAP). TAP is a quality improvement framework that works by:
- Supporting hospital-acquired infection (HAI) prevention and reduction
- Targeting locations with excess HAIs and implementing interventions
- Identifying gaps in prevention and opportunities for improvement, which serve as real-time teaching moments for multidisciplinary staff
However, manually aggregating data from disparate sources such as antibiograms and TAP can be a daunting and time-consuming task. All this information can be streamlined through the use of an electronic clinical surveillance solution. While your staff focuses on consultation and education, clinical surveillance can:
- Automatically identify potential or actual HAIs
- Aggregate and analyze infection prevention data (including risk-adjusted Standardized Infection Ratios (SIRs)
- Streamline daily surveillance workflows
Budgeting your time for analysis and patient care is critical as staff shortages continue to impact team capacity.