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Determining infection prevention staffing needs for the pediatric ambulatory and procedural care setting
Lindsay K Weir1, Jennifer A Ormsby1, Ana M Vaughan-Malloy1
1Infection Prevention and Control, Boston Children's Hospital, Boston, MA.
Insights
Existing infection preventionist (IP) staffing may be insufficient for complex pediatric ambulatory settings. A needs assessment revealed a requirement for 4.5 full-time equivalents (FTEs) to manage current demands.
Area of Science:
- Healthcare Management
- Infection Prevention and Control
- Pediatric Healthcare
Background:
- Current infection preventionist (IP) staffing ratios may not adequately address the complexity and scope of non-inpatient healthcare settings.
- Pediatric ambulatory and procedural operations present unique challenges for infection prevention and control (IPC).
Purpose of the Study:
- To determine the current infection preventionist (IP) staffing level required for pediatric ambulatory and procedural operations.
- To assess the complexity and scope of infection prevention needs in these settings.
Main Methods:
- A needs assessment adapted from previous studies was conducted.
- Infection preventionists (IPs) in ambulatory/procedural locations were surveyed on clinical complexity and time spent on IPC activities.
- Calculations were performed to determine total weekly IP hours and full-time equivalents (FTEs).
Main Results:
- Over half of surveyed locations reported at least one complexity indicator.
- Nearly 9% of locations reported three or more complexity indicators.
- A total of 181 hours per week were dedicated to ambulatory/procedural IPC, equating to 4.5 FTEs.
Conclusions:
- The findings supported the addition of 4 IP FTEs to the department.
- Increased FTEs will enhance ambulatory/procedural IPC support, regulatory readiness, and quality improvement.
- Assessing complexity and scope is valuable for advocating staffing increases and resource allocation.
Background:
Recent analyses suggest that existing infection preventionist (IP) staffing ratios do not reflect the scope of institutional needs after accounting for complexity and non-inpatient locations. We sought to determine the current IP staffing level required to address the complexity and scope of our pediatric ambulatory and procedural operations.
Methods:
This needs assessment was adapted from previous analyses by Bartles et al (2018). We surveyed IPs covering ambulatory/procedural locations regarding clinical complexity indicators and estimated hours per week spent engaged in IP activities. The reported hours were used to calculate total IP hours per week and associated full-time equivalents (FTEs).
Results:
Half (118/237) of surveyed locations/services reported at least 1 complexity indicator, while nearly 9% (21/237) reported 3 or more complexity indicators. IPs spent 181.0 h/wk focused on ambulatory/procedural locations, equating to 4.5 FTEs.
Discussion:
Infection prevention and control leadership used these findings to successfully add 4 IP FTEs to the department. These FTEs will allow increased ambulatory/procedural IP support, improved regulatory readiness, and increased quality improvement initiatives.
Conclusions:
Assessing the complexity and scope of pediatric ambulatory/procedural locations can be a valuable tool for (1) advocating for overall IP staffing increases at a system level and (2) determining the distribution of IP time and resources in such locations.
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