A year ago, when we were at the peak of the Ebola crisis, the Association for Professionals in Infection Control and Epidemiology (APIC) surveyed more than a 1,000 of its infection preventionist members working in U.S. acute care hospitals and found that only 6 percent felt that their hospitals were well prepared to receive a patient who may have Ebola.
One year later, in September 2015, APIC re-surveyed its members to see how the needle had moved. The good news is that the number of respondents who felt their hospitals were well prepared had doubled. However, an increase from 6 percent last year to 12 percent this year is alarmingly modest.
Even more concerning is that half of survey respondents (53 percent) reported that there was only one--or less than one--full-time infection preventionist at their organization. Of these, 45 percent work in facilities with more than 100 patient beds.
This lack of resourcing should set off alarm bells in hospital C-suites and in the halls of Congress. With barely one infection prevention expert at many institutions, how are hospitals expected to stay ahead of the next emerging threat or antibiotic-resistant superbug, let alone prepare for flu season, address existing infection concerns, conduct rounds, teach best practices, or be out on the floors observing units to make sure policies are being followed at the bedside? This teaching and coaching role is essential to patient safety. The lesson learned from the Ebola crisis is that facility-wide infection prevention programs are critical and require adequately trained, staffed and resourced infection prevention and control departments.
As a result of the Ebola crisis, the U.S. healthcare system expended tremendous energy, resources and time to help facilities prepare for patients with highly lethal infectious diseases. We cannot lose this focus or momentum. Healthcare leaders need to firmly establish infection prevention and control as a priority so that we can better protect patients and healthcare workers from not only Ebola, but from MRSA,C. difficile, and nightmare bacteria like CRE. While it is unlikely that most hospitals in the U.S. will ever see a case of Ebola, they are faced every day with the enormous challenge of antibiotic resistance and preventing healthcare-associated infections, which claim the lives of 75,000 patients each year.
We cannot wait for the next crisis to hit before we improve our infection prevention and control programs. It's hard to know what the "right" level of staffing is, and APIC recently undertook a MegaSurvey of the infection preventionist profession that we will share in 2016 to inform the dialogue about infection prevention staffing and resource levels. But while we work to understand what "right" looks like, patients can't wait. It is incumbent for healthcare facilities to take a hard look at the care and services they provide and make sure they are allocating the appropriate level of infection prevention and control personnel and resources to protect the patients they serve.
Susan A. Dolan, RN, MS, CIC is the president-elect of APIC and an infection preventionist at Children's Hospital Colorado. She spearheaded the crafting and passage of Colorado's first healthcare-associated infection reporting bill in 2006.