Assisting the infection preventionist: Use of artificial intelligence for health care-associated infection surveillance.

BACKGROUND: Health care-associated infection (HAI) surveillance is vital for safety in health care settings. It helps identify infection risk factors, enhancing patient safety and quality improvement. However, HAI surveillance is complex, demanding specialized knowledge and resources. This study investigates the use of artificial intelligence (AI), particularly generative large language models, to improve HAI surveillance. METHODS: We assessed 2 AI agents, OpenAI's chatGPT plus (GPT-4) and a Mixtral 8×7b-based local model, for their ability to identify Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) from 6 National Health Care Safety Network training scenarios. The complexity of these scenarios was analyzed, and responses were matched against expert opinions. RESULTS: Both AI models accurately identified CLABSI and CAUTI in all scenarios when given clear prompts. Challenges appeared with ambiguous prompts including Arabic numeral dates, abbreviations, and special characters, causing occasional inaccuracies in repeated tests. DISCUSSION: The study demonstrates AI's potential in accurately identifying HAIs like CLABSI and CAUTI. Clear, specific prompts are crucial for reliable AI responses, highlighting the need for human oversight in AI-assisted HAI surveillance. CONCLUSIONS: AI shows promise in enhancing HAI surveillance, potentially streamlining tasks, and freeing health care staff for patient-focused activities. Effective AI use requires user education and ongoing AI model refinement.

Infection preventionists in public health, consultant and academic roles: Results from the 2020 APIC MegaSurvey.

BACKGROUND: Infection preventionists (IPs) work and practice in a variety of roles across many practice settings. While the health care-based IP role has been well studied, less is known about IPs who work in public health, consultant, and academic roles. METHODS: Data were collected as a subset of the Association for Professionals in Infection Prevention and Control and Epidemiology 2020 MegaSurvey. Descriptive and bivariate analyses were performed to compare the responses of 147 IPs working in public health, consulting, or academic roles. RESULTS: Respondents identified their primary IP role as public health (40%), consulting (39%), or academic (21%). Most were White and non-Hispanic females working in long-term care, acute care, and outpatient settings. Most had over 11 years of experience in health care before IP, with nursing being the most common. More consultants were certified in infection control (74%). While half of the respondents in public health reported being certified in infection control, and a third had 6 or more years of experience in infection prevention and control, they reported the lowest annual salary and satisfaction with total compensation. DISCUSSION: These findings highlight the characteristics and contributions of infection prevention and control in nontraditional roles and settings. Certification and fair compensation are crucial factors for professional development and job satisfaction. CONCLUSIONS: These insights can guide future education, recruitment, and retention strategies for IPs in public health, consulting, and academic roles.

The role of spirituality, religiosity, and self-care on infection preventionist well-being: Results from a national survey in the United States.

BACKGROUND: The degree to which religiosity, spirituality, and self-care practices can improve well-being among infection preventionists is not well understood. METHODS: We surveyed infection preventionists from a random sample of United States hospitals in 2021. Multivariable logistic regression models were used to examine the associations between measures of spirituality, religiosity, and self-care and well-being. RESULTS: Our response rate was 47% (415/881). A total of 49% of respondents reported burnout, 17% reported increased feelings of uncaring, and 69% would choose to become an infection preventionist again. Most respondents found importance in spiritual well-being (88%), religious beliefs (82%), and self-care practices (87%). Spiritual well-being was associated with increased odds of choosing to become an infection preventionist again (odds ratio = 2.32, 95% confidence interval = 1.19-4.53, P = .01). DISCUSSION: Our national survey provides evidence that spiritual importance is associated with career satisfaction among infection preventionists. Our findings contribute to a general body of evidence suggesting spiritual importance may translate to higher flourishing and well-being via serving a higher purpose. CONCLUSIONS: Promoting spiritual well-being may positively influence career satisfaction and overall well-being among infection preventionists.

APIC Megasurvey 2020: Methodology and overview of results.

BACKGROUND: In 2015, The Association for Professionals in Infection Control and Epidemiology (APIC) conducted the first MegaSurvey of its members to understand key aspects of their practice. Given the evolving role of Infection preventionists (IPs), it is important to understand changes in and the current practice environments of IPs, their demographics, the organizations in which they practice and the relative importance of different domains of IP practice. METHODS: The MegaSurvey 2020 was a cross-sectional, electronic survey of IPs conducted by APIC between January 21 and February 28, 2020. Descriptive statistics were calculated to describe the participants in terms of their characteristics, practice setting, compensation and IP competencies. RESULTS: 2,030 APIC members (response rate 13%) participated in the study. Results indicated that the demographic characteristics of IPs remained the same between the 2015 and 2020 surveys. Similar to 2015 data, slightly less than half of respondents are currently certified and plan to recertify. Less than 50% of IPs reported feeling adequately satisfied with their overall compensation. IPs reported spending the largest proportion of their time on surveillance and epidemiologic investigations and the least amount of time on employee and occupational health, cleaning and sterilization and education/research. CONCLUSIONS: As the healthcare industry continues to evolve, public health emergencies persist, and regulatory requirements expand, the results of the APIC MegaSurvey can inform future educational initiatives, the development of programs and ongoing hiring and retention strategies for this critical profession.

[COVID-19 vaccination strategy for employees of German hospitals: results of a survey of infection control practitioners within the B-FAST project]. / COVID-19-Impfstrategien für Beschäftigte deutscher Kliniken: Ergebnisse einer Befragung von Leitungen der (Krankenhaus­)Hygiene im Rahmen des B-FAST-Projektes.

BACKGROUND AND AIM: At the beginning of the COVID-19 vaccination campaign in Germany, employees in medical facilities were prioritised for vaccination against SARS-CoV­2 due to the high risk of exposure and contact with vulnerable groups. Hospitals were therefore encouraged to organise and implement the vaccination of their employees as soon as possible. The aim of the study was to record the practice regarding the vaccination strategy for employees in German hospitals. METHODS: In a self-developed cross-sectional study, infection control practitioners of all German university hospitals as well as non-university hospitals in Lower Saxony and Bavaria were surveyed in March 2021. The data were stratified according to the characteristics of university hospitals and non-university hospitals. RESULTS: Of 416 invitations sent out, 100 questionnaires (university hospitals: 33; non-university hospitals: 67) were completed. University hospitals reported greater vaccination capacity than non-university hospitals, but a limiting factor was uncertain vaccine supply. Vaccination information campaigns were planned or had already been conducted in 89% of clinics. About two-thirds of the respondents (70%) said they did not plan to conduct antibody tests on vaccinated employees. A follow-up of vaccinated employees to detect possible SARS-CoV­2 infections by PCR was planned by 41% of the respondents. In case of detection of SARS-CoV­2 infection, 72% of the respondents had planned further diagnostic procedures. DISCUSSION: All hospitals were able to achieve rapid implementation of COVID-19 vaccination of their employees. At the time of the survey, there was also much uncertainty regarding the management of breakthrough infections as well as the need for booster vaccinations.

Developing an infection prevention program by leveraging the APIC competency model.

Health care systems are expanding and the health care industry is growing in complexity, necessitating the importance of competent Infection Preventionists (IPs). At Northwestern Medicine, a health care system consisting of diverse facilities with varied patient populations and environments of care, the need for a standardized approach to developing competent IPs became apparent. This Infection Prevention department utilized the APIC Competency Model to develop a framework for Infection Prevention program development, including a standardized orientation guide and career ladder.

[Expectations for Pharmacists and Pharmacy Education in AST Activities].

Since 2018, high expectations have been placed on the efforts of pharmacists in infectious disease diagnostic aid via Japan's antimicrobial stewardship team (AST). We will explain this while describing the process of diagnostic aid at our institution, a university hospital, and taking into account the point of view of what is required of pharmacist by infection control doctors when performing infectious disease diagnostic aid as well. At our hospital, we implement AST rounds as infectious disease diagnostic aid for positive blood cultures, bacterial culture results, fever, long-term administration of anti-bacterial medication, example consultation cases, etc. The number of rounds has been increasing over time, totaling 5654 cases in 2018. When performing infectious disease diagnostic aid, failure to also bear in mind infection control measures can result in failed treatment and outbreaks, so AST must coordinate with infection control team (ICT). Furthermore, when engaging in infectious disease diagnostic aid, pharmacists must also participate in clinical research in order to improve the quality of treatment. Although it also depends on the facility environment they are affiliated with, it would seem to be necessary for pharmacists to verify the knowledge obtained from clinical data using a fundamental approach. Moreover, conducting education for the doctor, pharmacist, and nurse trainees who make up their fellow and future staff is another vital role of AST pharmacists.

A job analysis of knowledge and tasks for the certification in infection control and epidemiology examination.

The Certification Board in Infection Control and Epidemiology, Inc. completed a 2020 Job Analysis to validate the contents of the Certification in Infection Control and Epidemiology (CIC) exam accurately reflects the work of the infection preventionist (IP). The Job Analysis provided evidence that knowledge and tasks were well to very well covered on the survey. These knowledge and task statements form the blueprint for the exam for the next 3-5 years.

Antimicrobial Stewardship and the Infection Control Practitioner: A Natural Alliance.

Antibiotic overuse and misuse has contributed to rising rates of multidrug-resistant organisms and Clostridioides difficile. Decreasing antibiotic misuse has become a national public health priority. This review outlines the goals of antimicrobial stewardship, essential members of the program, implementation strategies, approaches to measuring the program's impact, and steps needed to build a program. Highlighted is the alliance between antimicrobial stewardship programs and infection prevention programs in their efforts to improve antibiotic use, improve diagnostic stewardship for C difficile and asymptomatic bacteriuria, and decrease health care-associated infections and the spread of multidrug-resistant organisms.

Exploring the promise and reality of ward-based primary healthcare outreach teams conducting TB household contact tracing in three districts of South Africa.

BACKGROUND: Tuberculosis (TB) household contact tracing is a form of targeted active case-finding for which community health workers ('outreach teams') in South Africa are primarily responsible for its implementation. We conducted an exploratory qualitative study to understand the role of outreach teams in delivering TB household contact tracing. METHODS: The study took place in three districts of South Africa between May 2016 and February 2017. We conducted 78 in-depth interviews (IDI) (comprising 35 key stakeholders, 31 TB index patients and 12 HHCs) and five focus group discussions (FGD) (40 outreach team members in four FGDs and 12 community stakeholders in one FGD). RESULTS: Outreach teams contributed positively by working across health-related programmes, providing home-based care and assisting with tracing of persons lost to TB care. However, outreach teams had a limited focus on TB household contact tracing activities, likely due to the broad scope of their work and insufficient programmatic support. Outreach teams often confused TB household contact tracing activities with finding persons lost to TB care. The community also had some reservations on the role of outreach teams conducting TB household contact tracing activities. CONCLUSIONS: Creating awareness among outreach workers and clinic personnel about the importance of and activities related to TB household contact tracing would be required to strengthen the delivery of TB household contact tracing through the community-based primary health care teams. We need better monitoring and evaluation systems, stronger integration within a realistic scope of work, adequate training on TB household contact tracing and TB infection prevention control measures. Involving the community and educating them on the role of outreach teams could improve acceptance of future activities. These timely results and lessons learned should inform contact tracing approaches in the context of COVID-19.

Challenges and opportunities in recruiting, hiring and training infection preventionists across facility settings.

BACKGROUND: Recruitment of skilled professionals for the infection preventionist (IP) role is an ongoing priority for organizations. The objective of this study was to understand differences in recruitment, hiring and training by facility setting and discuss targeted strategies for diverse organizations. METHODS: A survey study investigated recruitment, hiring and training practices for IPs and stratified by facility location (multi-location health system (MLHS), urban, suburban and rural), specifically pertaining to job description requirements, background of candidates interviewed and hired and training programs. RESULTS: A Master's in Public Health degree was significantly more frequently listed on MLHS and urban facility job descriptions (37.3%, 43.7%, respectively) than suburban (27.4%) and rural facility job descriptions (17.2%)(P < .01). Respondents from MLHS (41.3%), urban facilities (47.0%), suburban facilities (41.7%) were more likely to interview public health professionals than rural facilities (20.3%, P = .003). Respondents from MLHS, (73.3%), urban (68.4%), and suburban (62.2%) facilities were significantly more likely to use local Association for Professionals in Infection Control and Epidemiology chapter for training compared to rural facilities (32.4%)(P < .001). CONCLUSIONS: Our results identified differences in facility setting with recruitment, hiring and training practices. Optimizing recruitment and training best practices will result in a large and well trained IP workforce and patient safety.

Infection preventionist retention and professional development strategies: Insights from a national survey.

This brief report explores why Infection Preventionists (IPs) leave their positions and strategies implemented to retain and professionally develop IPs. National survey data of over 500 APIC members found turnover is due to personal reasons, professional advancement opportunities and work-life balance challenges. In addition, IPs are retiring in great numbers. The creation of career pathways and providing an environment that supports work-life balance are novel strategies that could retain and professionally develop IPs.

A cross sectional study of organizational factors and their impact on job satisfaction and emotional burnout in a group of Australian nurses: infection control practitioners.

BACKGROUND: Infection control practitioners (ICPs) are a group of specialized nurses fundamental to effective healthcare infection prevention and control initiatives. Relative to other groups of nurses much less is known about their working conditions. Organizational factors may impact ICPs' levels of job dissatisfaction and emotional job burnout and, subsequently, their quality of practice. We measure a range of organizational factors to document the working conditions of ICPs and show how these are linked to job satisfaction and emotional burnout in a sample of Australian ICPs. METHODS: We conducted a cross sectional study using an online survey. All employed ICPs in 50 of the largest public hospitals in Australia were invited to participate. One hundred and fifty three ICPs completed the survey. RESULTS: ICPs are moderately to highly satisfied with their job but show high levels of emotional burnout, time pressure and cognitive demands. Low job satisfaction was associated with less job control, low perceived organizational support and poor communication. In contrast, emotional burnout was associated with high time pressure and cognitive demands coupled with poor communication. DISCUSSION: This study provides new evidence about the organizational context of ICPs in Australia, and about the factors that impact on job satisfaction and emotional burnout. These findings may be used to modify national infection prevention and control programs to suit local organizational contexts. Further research is needed to determine the precise nature of these relationships and the downstream impacts on hospital-wide infection control outcomes. CONCLUSIONS: Organizational context and factors are important to consider when evaluating the impact and implementation of infection control programs.

Prise en charge du travailleur de santé exposé au nouveau coronavirus (SARS-CoV-2) dans un établissement de santé. Recommandations provisoires, 13 avril 2020

Cet outil aidera à déterminer le risque d’infection par le virus du SRAS-CoV-2 chez les professionnels de la santé qui ont été exposés à un patient atteint de la maladie à coronavirus (COVID-19), guidera les comportements nécessaires et fournira ensuite des recommandations pour la bonne prise en charge de ces professionnels de la santé, en fonction du risque d’infection.

Mental health status among Chinese healthcare-associated infection control professionals during the outbreak of coronavirus disease 2019: A national cross-sectional survey.

ABSTRACT: Recently, the coronavirus disease 2019 (COVID-19) epidemic has greatly threatened global public health. The responsibility of healthcare-associated infection control professionals (ICPs) is to prevent and control the nosocomial infections. The mental health status of ICPs deserves more attention, however, the correlational research is still lacking. This study aims to investigate the incidence and risk factors of mental health status among ICPs in China during the outbreak of COVID-19.A national cross-sectional survey was performed. The online questionnaire was completed by 9228 ICPs from 3776 hospitals throughout China. Data collection tools were used, including demographics data questionnaire, the Chinese version of the 12-item general health questionnaire (GHQ-12) and the Chinese version of the psychological capital questionnaire (PCQ) for medical staff. Univariate and multivariable analyses were conducted.The total score of mental health of Chinese ICPs was 3.45 ±â€Š2.57. 5608 (60.77%) ICPs might have mental health problems. The psychological capital was in the upper-middle level with an average score of 3.72 ±â€Š0.38. An increased mental health problem risk was associated with the greater self-efficacy and working in the public hospital; a significantly lower risk was obtained by working in the second-class hospital rather than in the third-class hospitals. Besides, mental health problem risk of ICPs working in hospitals of the western economic region or northeast economic region was more significant than that in hospitals of the central economic region. However, a lower risk was caused by the unmarried than married, and working years in department ≤1 year contributed to the lower risk than that >20 years. Moreover, fewer working hours per week, higher values of hope, and optimism each were contributed to a lower risk.Chinese healthcare-associated ICPs were under different levels of mental health problems in fighting against COVID-19. More importantly, we should actively deal with the mental health problem of ICPs and help them get rid of psychological disorders.

Recruitment and hiring practices in United States infection prevention and control departments: Results of a national survey.

BACKGROUND: Infection prevention is a profession that requires highly specified skills and clinical experience. Infection Preventionists (IPs) direct interventions that protect patients from health care-associated infections across clinical and community settings. To enhance the hiring and recruitment of diverse IPs, it is key to understand current recruitment and hiring practices METHODS: A national on-line survey was performed with members of the Association for Professionals in Infection Control and Epidemiology (APIC) who participate in the recruitment and hiring of IPs in their organization. Descriptive statistics were calculated for respondent and organizational demographics, IP recruitment strategies and hiring practices. RESULTS: In the fall of 2019, 522 APIC members from 101 of 113 APIC chapters (89% chapter response rate) participated in the survey. A vacant IP position was reported by 25% (n = 126) of respondents. Recent IP hires were primarily nurses (70%; n = 346) recruited from outside the organization (54%; n = 270). Online job-boards (eg, Indeed and Monster) and internal organizational job postings were the most frequently used recruitment strategies. CONCLUSIONS: The results provide a summary of practices for IP recruitment and hiring that can inform local and national initiatives to increase the number and professional diversity of IPs.

Developing and implementing an infection prevention and control program for a COVID-19 alternative care site in Philadelphia, PA.

BACKGROUND: On March 27, 2020, the city of Philadelphia was given permission by Temple University to convert the Liacouras Center gymnasium to an alternate care site (ACS) to treat low-acuity COVID-19 patients. ACSs, especially those created to specifically care for infectious patients, require a robust infection prevention and control (IPC) program. METHODS: The IPC program was led by a physician and nurse partnership, both of whom had substantial experience developing IPC programs in US and low-resource settings. The IPC program was framed on a previously described conceptual model commonly referred to as the "4S's": Space, Staff, Stuff, and Systems. RESULTS: The gymnasium was transformed into red, yellow, and green infection hazard zones. The IPC team trained 425 staff in critical IPC practices and personal protective equipment standards. Systems to detect staff illness were created and over 3,550 staff health screening surveys completed. DISCUSSION: Use of existing guidance and comprehensive facility and patient management assessments guided the development of the IPC program. Program priorities were to keep staff and patients safe and implement procedures to judiciously use limited resources that affect infection transmission. CONCLUSION: Planning, executing, and evaluating IPC standards and requirements of an ACS during a pandemic requires creative and nimble strategies to adapt, substitute, conserve, reuse, and reallocate IPC space, staff, stuff, and systems.

Halting a SARS-CoV-2 outbreak in a US Veterans Affairs nursing home.

A Veterans Affairs long term care facility on Long Island New York was confronted with a COVID-19 outbreak in late March to Mid-April 2020. Faced with a dwindling supply of PPE, the Infection Control team distributed supplies saved for a possible Ebola outbreak. A COVID unit was created within the nursing home facilitating the geographic isolation of cases; universal testing of residents and employees allowed for the implementation of proper quarantine measures. It was a multidisciplinary team approach led by the Infection Control team that successfully contained this outbreak.