A groundbreaking study, recently published in the American Journal of Infection Control, affirms that healthcare-associated infections tend to rise when there’s an inadequate number of personnel involved in infection prevention and control. The researchers applied an innovative online calculator, specifically designed to provide recommendations tailored to each facility’s conditions, instead of proposing universal infection preventionists (IPs) per inpatient bed ratio.
The study assessed the infection prevention staffing requirements across 390 acute care hospitals. The computation of the ideal number of IPs was contingent on several factors such as the existence of an emergency department, burn unit, inpatient rehabilitation unit, or stem cell transplant unit. Astonishingly, the tool revealed that a majority (79.2%) of the evaluated hospitals were dealing with an insufficient number of staff in infection control. The calculator assumes a standard baseline staffing of 1 full-time IP for every 85 beds.
The observed staffing levels varied widely, from 1 IP for every 40 beds in small hospitals (less than 25 beds) to a high of 1 IP per 161 beds in hospitals accommodating 301 to 400 beds. The median full-time equivalent (FTE) IP to bed ratio across the 390 hospitals was 121.0 beds.
Interestingly, the authors noted, ‘the IP FTE to bed ratio witnessed a dip as the bed count increased, meaning larger hospitals had fewer IP FTEs per bed.’ The study also highlighted that nearly 90% of hospitals with more than 100 beds and 54.8% of hospitals with 100 or fewer beds had lower and higher than expected staffing, respectively.
Furthermore, the study unearthed a significant correlation between IP staffing levels and the incidence of healthcare-associated infections like CLABSI, CAUTI, Clostridioides difficile infections, and colon surgical site infections. Notably, around 90% of hospitals with higher than expected staffing fell into the low-CAUTI bracket, contrasting with only 57.6% of hospitals staffed below the expected level. Similarly, 25% of understaffed hospitals had higher colon surgical site infection rates, almost double compared to 14.6% in well-staffed hospitals.
Vindicating the pivotal need for optimal IP staffing, Tania Bubb, PhD, RN, and the APIC president of 2024 revealed, ‘there’s an incontrovertible tie between adequate infection prevention and control resources and patient safety.’ The authors also shed light on the propensity of COVID-19 to cause ‘brainstem insult’ leading to clusters of physical long-COVID symptoms. They further touched upon the swift response of the Sabin Vaccine Institute in shipping vaccines at the behest of the Rwanda government’s request.
All this crucial data underscores the pressing need for hospitals to prioritize appropriate staffing levels in infection prevention to safeguard the health of their patients and, by extension, public health.
Source: https://www.cidrap.umn.edu/misc-emerging-topics/understaffed-hospitals-have-higher-rates-infection