State of infection prevention in US hospitals enrolled in the National Health and Safety Network.
BACKGROUND
This report provides a national cross-sectional snapshot of infection prevention and control programs and clinician compliance with the implementation of processes to prevent health care-associated infections (HAIs) in intensive care units (ICUs).


METHODS
All hospitals, except Veterans Affairs hospitals, enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation involved completing a survey assessing the presence of evidence-based prevention policies and clinician adherence and joining our NHSN research group. Descriptive statistics were computed. Facility characteristics and HAI rates by ICU type were compared between respondents and nonrespondents.


RESULTS
Of the 3,374 eligible hospitals, 975 provided data (29% response rate) on 1,653 ICUs, and there were complete data on the presence of policies in 1,534 ICUs. The average number of infection preventionists (IPs) per 100 beds was 1.2. Certification of IP staff varied across institutions, and the average hours per week devoted to data management and secretarial support were generally low. There was variation in the presence of policies and clinician adherence to these policies. There were no differences in HAI rates between respondents and nonrespondents.


CONCLUSIONS
Guidelines for IP staffing in acute care hospitals need to be updated. In future work, we will analyze the associations between HAI rates and infection prevention and control program characteristics, as well as the inplementation of and clinician adherence to evidence-based policies.
Center for Health Policy, Columbia University School of Nursing, New York, NY. Electronic address: ps2024@columbia.edu.
Patricia W
PW
Stone
Center for Health Policy, Columbia University School of Nursing, New York, NY.
Monika
M
Pogorzelska-Maziarz
Center for Health Policy, Columbia University School of Nursing, New York, NY; Center for Health Policy, Columbia University School of Nursing, New York, NY.
Carolyn T A
CT
Herzig
Centers for Disease Control and Prevention, Atlanta, GA.
Lindsey M
LM
Weiner
Columbia University College of Physicians and Surgeons, New York-Presbyterian Hospital, New York, NY.
E Yoko
EY
Furuya
RAND Corporation, Boston, MA.
Andrew
A
Dick
Center for Health Policy, Columbia University School of Nursing, New York, NY; Mailman School of Public Health, Columbia University, New York, NY.
Elaine
E
Larson
D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods*; D014481:United States
Health care–associated infection; Infection preventionist; Policy; Quality; Staffing