A lack of infection prevention and control staffing leads to more healthcare-associated infections, according to a new study published today in the American Journal of Infection Control.
The study is based on a new online calculator aimed at providing facility-specific recommendations for infection prevention staffing instead of a standard infection preventionists (IPs) per inpatient bed.
Researchers used the calculator to analyze the IP staffing needs at 390 acute care hospitals and the number of optimal IPs was based on factors such as the presence of an emergency department, burn unit, stem cell transplant unit, or inpatient rehabilitation unit.
The majority of the 390 hospitals surveyed (79.2%) were understaffed according to the calculator in infection control personnel, which assumed a baseline staffing level of 1 full-time IP per 85 beds.
Staffing levels ranged from 1 IP per 40 beds at small hospitals (fewer than 25 beds) to a peak of 1 IP per 161 beds in hospitals with 301 to400 beds. Overall, the median IP full-time equivalent to bed ratio was 121.0 beds for the 390 hospitals.
"The IP FTE [full-time employee] to bed ratio decreased as the hospital bed size increased, with larger programs having less IP FTE per bed," the authors wrote. Almost 90% (89.6%, 277) of the hospitals with more than 100 beds were considered to have below expected staffing while 54.8% (51) of hospitals with 100 or fewer beds were considered to have above expected staffing.
Association between staffing levels and infections
The authors found a significant association between IP staffing levels and healthcare-associated infections, including central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), Clostridioides difficile infections, and colon surgical site infections.
Almost 90% of hospitals that were staffed above expected were in the low CAUTI range, compared to only 57.6% of hospitals that were staffed at a below than expected level. In 25% of hospitals that were staffed below expected levels, there were higher colon surgical site infection rates compared to only 14.6% of the hospitals staffed above expected levels.
This study lays to rest any doubt about the critical need for appropriate levels of IP staffing.
"This study lays to rest any doubt about the critical need for appropriate levels of IP staffing, identifying an undeniable link between sufficient infection prevention and control resources and patient safety, as measured by rates of healthcare-associated infections," said Tania Bubb, PhD, RN,, the 2024 APIC president of the Association for Professionals in Infection Control (APIC) said in a press release from the group.
