APIC Calls on Healthcare Facilities to Assess Infection Preventionist Workloads and Reprioritize Critical Patient Safety Work

The Association for Professionals in Infection Control and Epidemiology (APIC) has created the IPC Acuity Scale, a free, downloadable tool that organizes infection prevention and control tasks into categories that should remain high priority, as well as those that can be delegated to trained non-IP staff or set aside altogether during times of overwork, such as during the pandemic.

“APIC is concerned that the COVID-19 Omicron surge is overloading infection preventionists (IPs) such that administrative tasks are interfering with their ability to perform critical patient safety and infection surveillance work inside our nation’s healthcare facilities," says APIC president Linda Dickey, RN, MPH, CIC, FAPIC. “IPs are the only healthcare professionals with specialized expertise in spotting clusters of infections and integrating evidence-based strategies to limit their spread. Given the current Omicron surge, APIC is concerned that IPs are unable to perform the work that only they can do that optimizes safety for healthcare organizations. If our nation’s IPs are bogged down with data entry and other administrative work, they are less able to protect patients and staff from COVID transmission or the spread of drug-resistant organisms. Efforts to investigate clusters of infections or conduct surveillance for healthcare-associated infections may fall short amid the overwhelming amount of paperwork necessitated by the pandemic.

Dickey continues, “The current IP workload, combined with a shortage of IPs, requires healthcare leaders to work with their IPs and carefully examine where they should focus their efforts. APIC calls on healthcare leaders to provide support so that IPs can focus on their critical patient safety work.”

Infection Prevention and Control (IPC) Acuity Scale for Crisis Situations

  • EMPHASIZE: Make high priority
    Updating and providing education/support for personal protective equipment (PPE) donning/doffing practices and supporting changes in practices as new guidelines emerge
  • Surveillance activities for high-risk, high-impact healthcare-associated infections (HAIs)
  • Investigating clusters/urgent events (floods, foodborne outbreaks, etc.), providing response
    guidance and reporting (COVID and non-COVID)
  • Attending COVID related operations/incident command/ planning meetings and providing IPC input
    on COVID-related protocols
  • Rounding to support staff, provide consultation, assess correct isolation precautions, etc.
  • Patient-to-patient and employee-to-patient contact tracing*
  • Vetting new PPE and low-level disinfection products (especially when supply chain issues emerge)
  • Construction design input for high-priority projects that cannot be delayed
  • Regulatory support during surveys, unannounced inspections

LESSEN EMPHASIS: Consider delegating to trained non-IP staff

  • Rounding on utilization of PPE and low-level disinfection practices
  • Vaccine clinic staffing
  • Administrative and/or data analysis tasks related to IPC surveillance (e.g. consider outsourcing
    surveillance with IP validation or having the IP per-form the surveillance and utilize data analysts to
    build charts, graphs, etc.)
  • Data entry for reportable conditions
  • PPE counts

DECREASE EMPHASIS: Consider setting aside during crisis

  • Attendance at committee meetings unrelated to emergency, unless deemed critical
  • Employee-to-employee contact tracing
  • Performance improvement teams with infection prevention leadership unrelated to emergency,
    unless deemed critical
  • Antimicrobial stewardship responsibilities specific to infection prevention
  • Observational audits
  • Surveillance activities for lower-risk, lower-impact healthcare-associated infections (HAIs)
  • Participating in non-infection prevention related environment of care (EOC) rounds, routine policy
    and procedure review

Source: Association for Professionals in Infection Control and Epidemiology (APIC)