Providence St Joseph Health System, Renton, WA.
Providence Southwest Washington Service Area, Centralia, WA.
Am J Infect Control. 2018 May;46(5):487-491. doi: 10.1016/j.ajic.2017.11.006. Epub 2018 Jan 4.
This article describes a large nonprofit health care system's approach at quantifying the actual number of infection preventionist (IP) and relative support staff required to build and sustain effective infection prevention programs.
A list of all physical locations within the organization requiring infection prevention coverage were identified via survey, including department-level detail for 34 hospitals, 583 ambulatory sites, and 26 in-home and long-term care programs across 5 states. Required IP activities for each physical location were also tallied by task. Type of activity, frequency (times per year), hours per activity, and total number of locations in which each activity should occur were determined. From this, the number of hours per week of infection prevention labor resources needed was calculated.
Quantitative needs assessment revealed actual labor need to be 31%-66% above current benchmarks of 0.5-1.0 IP per 100 occupied beds. When aggregated across the organization, the comprehensive review results yielded a new benchmark of 1.0 infection prevention full-time equivalent per 69 beds if ambulatory, long-term care, or home care are included.
Size, scope, services offered, populations cared for, and type of care settings all impact the actual need for IP coverage, making the survey benchmarks available in the literature invalid. A comprehensive assessment of health care organization composition and structure is necessary prior to determining the IP staffing needs for that organization.
本文介绍了一家大型非营利性医疗保健系统在量化建立和维持有效感染预防计划所需的实际感染预防师(IP)和相关支持人员数量方面的方法。
通过调查确定了组织内所有需要感染预防覆盖的物理位置,包括 5 个州的 34 家医院、583 个门诊点以及 26 个家庭和长期护理项目的部门级详细信息。还按任务对每个物理位置的所需 IP 活动进行了计数。确定了每种活动的活动类型、频率(每年次数)、每次活动的小时数以及每种活动应发生的位置总数。由此计算出每周感染预防劳动力资源所需的小时数。
定量需求评估显示,实际劳动力需求比目前 0.5-1.0 名 IP 每 100 张占用床位的基准高出 31%-66%。如果将门诊、长期护理或家庭护理纳入其中,对整个组织的综合审查结果得出了新的基准,即每 69 张床位配备 1.0 名感染预防全职当量。
规模、范围、提供的服务、护理的人群以及护理环境的类型都会对 IP 覆盖的实际需求产生影响,使得文献中提供的调查基准无效。在确定该组织的 IP 人员配备需求之前,必须对医疗保健组织的组成和结构进行全面评估。