Numbing numbers: IPs report deep cuts
'We are as low as we can go.'
The principal findings of a recent economic survey by the Association for Professionals in Infection Control and Epidemiology include the following:
- Cuts are affecting the essence of infection prevention — a quarter of respondents have reduced surveillance activities to detect, track, and manage health care-associated infections (HAIs).
- Education budgets have been hard hit. Three-quarters of those whose budgets were cut have experienced decreases for the education that trains health care workers in preventing the transmission of HAIs. Half saw reductions in overall budgets for infection prevention, including money for technology, staff, education, products, equipment, and updated resources; nearly 40% had layoffs or reduced hours, and a third experienced hiring freezes.
- Cuts have impaired infection prevention programs — a third of the respondents say cuts in staffing and resources reduce their capacity to focus on infection prevention.
- State laws requiring public reporting of health care-associated infections make it harder to focus on preventing infections, said half the respondents.
- Forty-five percent said they have less support to attend APIC events; 44% attend fewer meetings at their hospital or clinic; 42% have fewer environmental and walking rounds; 38% have cut education of staff, visitors, and patients.
- Technology is lagging. Only one in five respondents has data-mining programs, electronic surveillance systems that allow infection preventionists to identify and investigate potential infections in real time enabling them to intervene quickly.
- Infection prevention departments are understaffed. Almost two-thirds of respondents have one or less than one full-time equivalent position dedicated to infection prevention, while almost 90% have zero or less than one full-time equivalent for clerical or analytic support.
- Three-quarters of survey respondents work at acute care hospitals; Six in 10 also supervise infection prevention for outpatient clinics.
IPs comment on harsh work conditions
The APIC survey included the following comments by infection preventionists:
- "We have so much more to do because of 29 patient safety goals and mandatory reporting, even though I am the only full-time person."
- "I am unable to keep up with the workload, so I have to do it on my own time. I cannot go over my [normal work hours]."
- "As the responsibilities and time required to do the work of infection prevention have increased, the staffing level and support have decreased, leaving us to do much more with much less. This year, the staff influenza immunization rate decreased dramatically from 60% to 44% as we simply were not available to continue offering vaccines after the initial building-based clinics."
- "I had crafted a very nice plan to justify another position, but it was not approved due to the severe economic environment."
- "We did not replace an employee health nurse, and now the infection preventionist does both."
- "I am in my office 80% of the time. I do not have time to do my surveillance — I haven't been in the OR for eight months."
- "We added responsibilities for employee health, and our state added mandatory reporting."
- "With mandatory reporting . . . the focus has become on data collection and reporting with very little time on the prevention of infections or process monitoring."
- "We have no resources for data entry or clerical support."
- "We are as low as we can go."
- "We have an open position, but no one is applying."
- "An IP resigned due to the working conditions."
- "Our hiring freeze was lifted after the best candidate was lost."
- "Pay cuts will result in me looking for other employment."
- "Administration and purchasing have declared that the system is into cost savings, particularly supply cost savings, so the evidence-based implementations and products that reduce infections have been eliminated."
- "I am a new infection preventionist and was looking forward to attending the APIC Infection Prevention 101 class. Due to the economy, I will not be able to attend."
- "I cannot spend on education or improved technology."
- "We cannot obtain funding for data mining tools."
APIC's call to action for IP program support
Cost and consequences of health care infections
The principal findings of a recent economic survey by the Association for Professionals in Infection Control and Epidemiology include the following:Article Limit Reached
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