Leaders from the Association for Professionals in Infection Control and Epidemiology held a news briefing Oct. 24 to discuss the results and implications of the organizations national survey, which asked APICs infection preventionist members at U.S. hospitals, How prepared is your facility to receive a patient with the Ebola virus?
Of the 1,039 U.S.-based respondents working in acute care hospitals, only about 6% reported the facility was well-prepared, while about 5% said it was not prepared. The remaining responses reported various levels of preparedness in between the two extremes, with the majority (40%) indicating they were somewhat prepared. Survey responses were received from hospitals that ranged in size from less than 100 to more than 400 beds.
According to the survey, conducted Oct. 10-15, one in two hospitals (51%) had only one or less than one full-time equivalent infection preventionist on staff.
The results paint a dismal picture, said Katrina Crist, MBA, chief executive officer of APIC, during the news briefing. Among hospitals with zero to one IPs on staff, 4% felt well-prepared to receive a patient with the Ebola virus, compared to 31% of survey respondents with 11 or more infection preventionists on staff, said Crist, showing those facilities with larger IP staffs feel more prepared in dealing with the Ebola virus.
Infection preventionists are experts in identifying sources of infections and limiting their transmission in healthcare facilities; they use their unique skill set to ensure healthcare professionals are operating in a manner that keeps patients, visitors, volunteers, employees, and healthcare providers safe from infectious diseases, according to APIC.
The new APIC survey underscores the crucial need for more infection preventionists in healthcare facilities throughout the U.S., in the interest of patient and staff health and safety, according to APIC leaders. The Ebola outbreak illustrates why facility-wide infection prevention programs are critical and require adequately trained, staffed and resourced infection control departments, Crist said. The unique skill set of the infection preventionist is needed to get out in front of this outbreak and prevent the next public health issue from escalating to a crisis.
Because infection prevention programs are underresourced, infection preventionists dont have the time necessary to conduct regular rounds and observe and teach staff on the units and at the bedside, said Linda Greene, MPS, RN, CIC, member, APIC Regulatory Review Panel. The Ebola crisis has shown everyone how important it is that all healthcare workers, especially those on the frontlines, understand and practice correct infection control practices, according to Greene. It serves as a wake-up call to all of us.
At the very least, every healthcare facility should be ready to perform the initial assessment on a patient who may have Ebola, isolate the patient and communicate within and outside the facility, said Greene. From there, every facility should be prepared to either properly treat or transfer the patient. Healthcare workers in ambulatory care centers and physician groups also should be ready to assess, isolate and communicate, according to Greene.
Healthcare organizations must perform a risk assessment to determine who will come into contact with a possible Ebola patient, and make sure those who are on the frontlines of care are trained and prepared, said Greene. Ancillary staff, for example, those in the laboratory, radiology and the respiratory department, must be included in the training.
There also is legitimate concern among IPs who are stretched beyond their capacity and wear multiple hats, that they will miss other infectious diseases, like MRSA, enterovirus and CRE, according to Jennie Mayfield, MPH, BSN, CIC, president of APIC. The current crisis demonstrates our lack of surge capacity and should concern everyone.
According to the CDC, about 1 in 25 people in the U.S. get healthcare-associated infections and nearly 75,000 people die each year with these infections, about twice the number who die from auto accidents. Healthcare-associated infections cost the U.S. healthcare system in excess of $30 billion annually. Many of these infections can be prevented with proper infection prevention practices, according to APIC.
In response to the survey results, APIC is calling on healthcare facilities to assess their infection prevention programs by looking at all the care and services provided by the institution and determining the appropriate level of personnel and resources necessary to meet the increased need.
APIC is urging facilities to focus on three aspects of infection prevention in order to effectively protect healthcare workers, patients and the public.
Personnel Ebola readiness demands intense, in-person training and drilling led by infection prevention experts, adequate infection prevention staffing is critical.
Training To ensure that guidelines are followed precisely 100% of the time, healthcare workers must be trained and drilled on safety protocols so that they can demonstrate proficiency in essential infection control practices.
Technology and equipment To maximize efficiencies and provide real-time data to help infection preventionists detect and control infectious diseases, healthcare facilities must invest in infection tracking and monitoring technology.
For more about the survey and APIC, go to www.apic.org.