Columbia University School of Nursing, New York, NY.
Am J Infect Control. 2013 Nov;41(11):959-64. doi: 10.1016/j.ajic.2013.04.008. Epub 2013 Jul 20.
The role of infection preventionists (IPs) is expanding in response to demands for quality and transparency in health care. Practice analyses and survey research have demonstrated that IPs spend a majority of their time on surveillance and are increasingly responsible for prevention activities and management; however, deeper qualitative aspects of the IP role have rarely been explored.
We conducted a qualitative content analysis of in-depth interviews with 19 IPs at hospitals throughout the United States to describe the current IP role, specifically the ways that IPs effect improvements and the facilitators and barriers they face.
The narratives document that the IP role is evolving in response to recent changes in the health care landscape and reveal that this progression is associated with friction and uncertainty. Tensions inherent in the evolving role of the IP emerged from the interviews as 4 broad themes: (1) expanding responsibilities outstrip resources, (2) shifting role boundaries create uncertainty, (3) evolving mechanisms of influence involve trade-offs, and (4) the stress of constant change is compounded by chronic recurring challenges.
Advances in implementation science, data standardization, and training in leadership skills are needed to support IPs in their evolving role.
为满足医疗保健质量和透明度的需求,感染预防专家(IPs)的角色正在不断扩大。实践分析和调查研究表明,IPs 大部分时间都用于监测,并越来越负责预防活动和管理;然而,IP 角色的更深层次的定性方面很少被探索。
我们对美国各地医院的 19 名 IP 进行了深入的访谈,进行了定性内容分析,以描述当前的 IP 角色,特别是 IPs 如何进行改进,以及他们面临的促进因素和障碍。
这些叙述记录了 IP 角色正在随着医疗保健领域的最新变化而演变,并揭示了这种发展与摩擦和不确定性有关。访谈中出现了 IP 角色演变所固有的 4 个广泛主题:(1)扩大的职责超出了资源范围,(2)角色界限的转变造成了不确定性,(3)不断变化的影响机制涉及权衡取舍,以及(4)不断变化的压力因持续出现的挑战而加剧。
需要在实施科学、数据标准化和领导力培训方面取得进展,以支持 IP 在其不断发展的角色中的发展。