Prevention of Infections Through Appropriate Staffing (PITAS)

通过适当的人员配置预防感染 (PITAS)

• 批准号: 10504786
• 负责人: Monika Pogorzelska-Maziarz
• 金额: $ 50万
• 依托单位: THOMAS JEFFERSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10504786
• 关键词: Prevention; Infections; Through; Appropriate; Staffing

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.

项目摘要：通过适当人员配备预防感染(PITAS)研究 在全国范围内，医疗保健相关感染(HAI)是急性护理医院代价高昂的患者安全问题。 感染预防专家(IP)和感染预防和控制(IPC)部门在 实施以证据为基础的政策和程序，以预防、缓解和控制禽流感。然而， 缺乏描述和验证适当的知识产权人员配置的证据。此外，新冠肺炎大流行已经 给医疗体系带来了巨大的压力。新出现的证据表明，这种大流行已经 导致在急性护理环境中HAI的比率增加。然而，大流行对IPC的影响 各部门，包括人员配置和资源，以及IPC的日常活动情况不详。我们设计了一个独特的 和创新研究，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禽流感方面的有效性。在多纳贝迪安的框架下 质量，我们提出了一项为期3年的混合方法研究：1)描述2011年至 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 关怀医院；2)量化新冠肺炎大流行对感染防控的影响 科室、HAI率和急诊医院的抗生素耐药率；以及3)制定深入的 了解新冠肺炎对急性呼吸道感染预防人员、国际预防中心资源和做法的影响 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 医疗安全网络(NHSN)HAI和人员配置数据(2011-2019年)，以检查IPC的有效性 减少HAI的人员配备、基础设施和流程。在目标2中，我们将对美国进行一项全国调查。 并将调查与NHSN(2011-2022)和CMS数据(2018-2022)联系起来，以检查 新冠肺炎。在目标3中，我们将与参与预防和控制感染的人员进行面谈。 20家医院。在我们早先由联邦政府资助的研究中，使用NHSN医院的纵向样本，我们发现 临床医生对捆绑护理的高依从性和积极的组织氛围与较低的HAI相关 ICU中的比率。我们现在建议对IPC人员配备对以下方面的影响进行更全面的审查 通过将分析扩展到ICU之外并包括其他类型的HAI来评估HAI。我们还将评估 新冠肺炎大流行对政府间委员会工作人员和基础设施的影响，这是以前没有 学习。作为早期和新的研究者，我们代表了跨学科和跨学院的缩影 研究。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，完善心理测量乐器，并填补 证据中的一个重要漏洞。这项研究的结果将为加强IPC能力提供证据 并在急救医院做好准备，以便更有效地应对未来的传染病危机。