Prevention of Infections Through Appropriate Staffing (PITAS)

通过适当的人员配置预防感染（PITAS）研究 在全国范围内，医疗相关感染（HAI）是急诊医院中代价高昂的患者安全问题。 感染预防师（IP）和感染预防和控制（IPC）部门在以下方面发挥着不可或缺的作用： 实施以证据为基础的政策和程序，以预防、减轻和控制HAI。然而，在这方面， 缺乏描述和证实适当的执行伙伴人员配置的证据。此外，COVID-19疫情已 给医疗系统带来了巨大的压力新出现的证据表明， 导致急性护理环境中HAI的发生率增加。然而，疫情对IPC的影响 部门，包括人员配备和资源，以及日常IPC活动是未知的。我们设计了一个独特的 和创新的研究，以确定IPC部门如何应对大流行和 IPC基础设施和流程在预防HAI方面的有效性。在多纳贝迪安的 质量，我们提出了一个3年的混合方法研究：1）描述从2011年到2012年IPC计划的演变， 2019年，并确定IPC人员配置，基础设施和流程在预防急性HAI方面的有效性 护理医院; 2）量化COVID-19大流行对感染预防和控制的影响 急性护理医院的科室、HAI率和抗生素耐药性率;以及3）制定一项深入的 了解COVID-19对感染预防工作者的影响，IPC资源和急性 护理医院在目标1中，在我们以前工作的基础上，我们将把医院调查与纵向国家调查联系起来。 医疗保健安全网络（NHSN）HAI和人员配置数据（2011-2019），以检查IPC的有效性 在减少人力资本投资方面的人员配置、基础设施和流程。在目标2中，我们将进行一项全国性的调查， 将调查与NHSN（2011-2022）和CMS数据（2018-2022）联系起来，以检查 2019冠状病毒病。在目标3中，我们将与参与感染预防和控制的人员进行面谈， 20家医院在我们早期的联邦资助工作中，使用NHSN医院的纵向样本，我们发现， 临床医生对捆绑式护理高依从性和积极的组织氛围与较低的HAI相关 在ICU里。我们现在建议对IPC人员配置的影响进行更全面的审查， 通过将分析扩展到ICU以外并包括其他类型的HAI来评估HAI率。我们还将评估 COVID-19大流行对IPC员工和基础设施的影响，这是一个以前没有 研究了作为早期和新的研究者，我们代表了跨学科和校际的缩影 research.我们设计了一项创新的研究，建立在我们与 国际知名的研究人员和NHSN医院，完善心理测量声音仪器，并填补 证据中的一个重要空白。本研究的结果将为加强IPC能力提供依据 并在急症护理医院做好准备，以更有效地应对未来的传染病危机。

Project Summary: Prevention of Infections Through Appropriate Staffing (PITAS) Study Nationally, healthcare-associated infections (HAIs) are a costly patient safety concern in acute care hospitals. Infection Preventionists (IPs) and infection prevention and control (IPC) departments play an integral role in implementing evidence-based policies and procedures to prevent, mitigate and control HAIs. However, evidence describing and validating appropriate IP staffing is lacking. In addition, the COVID-19 pandemic has placed an enormous strain on the healthcare system. Emerging evidence suggests that the pandemic has resulted in increased rates of HAI in the acute care setting. However, the impact of the pandemic on IPC departments, including staffing and resources, and on routine IPC activities is unknown. We designed a unique and innovative study to determine how IPC departments have responded to the pandemic and the effectiveness of IPC infrastructure and processes in preventing HAIs. Guided by Donabedian’s framework of quality, we propose a 3-year mixed method study to: 1) Describe the evolution of IPC programs from 2011 to 2019 and determine the effectiveness of IPC staffing, infrastructure and processes in preventing HAI in acute care hospitals; 2) Quantify the impact of the COVID-19 pandemic on infection prevention and control departments, HAI rates and rates of antibiotic resistance in acute care hospitals; and 3) Develop an in-depth understanding of the impact of COVID-19 on infection preventionists, IPC resources and practices in acute care hospitals. In Aim 1, building upon our previous work, we will link hospital surveys to longitudinal National Healthcare Safety Network (NHSN) HAI and staffing data (2011-2019) to examine effectiveness of IPC staffing, infrastructure and processes on reducing HAI. In Aim 2, we will conduct a national survey of U.S. hospitals and link the survey to NHSN (2011-2022) and CMS data (2018-2022) to examine the impact of COVID-19. In Aim 3, we will conduct interviews with personnel involved in infection prevention and control in 20 hospitals. In our earlier federally-funded work, using a longitudinal sample of NHSN hospitals, we found that high clinician compliance with bundled care and positive organizational climate were associated with lower HAI rates in ICUs. We now propose to develop a more comprehensive examination of the impact of IPC staffing on HAI rates by expanding the analysis beyond the ICU and including other types of HAI. We will also evaluate the impact of the COVID-19 pandemic on IPC staffing and infrastructure, which is an area previously not studied. As Early Stage and New Investigators, we represent the epitome of interdisciplinary and intercollegiate research. We have designed an innovative study that builds upon our established relationship with internationally-renown researchers and NHSN hospitals, refines psychometrically sound instruments, and fills an important gap in the evidence. The results of this study will provide the evidence to strengthen IPC capacity and preparedness in acute care hospitals to more effectively respond to future infectious disease crisis.