Effects of Expanding Infection Control Team Functions on Device-Associated HAIs: A Leadership-Oriented Intervention...

Background/Objectives: The effective prevention and control of healthcare-associated infections (HAIs) require the active engagement of clinical staff, which depends on strong relationships between the Infection Prevention and Control Team (IPCT) and frontline healthcare personnel. The role of the Infection Control Physician (ICP) as a clinical leader is essential for supporting evidence-based practice and fostering collaboration. This study aimed to demonstrate the impact of leadership-oriented interventions-particularly the introduction of ICP consultations in hospital wards-on HAI surveillance quality. Methods: A retrospective observational quasi-experimental study was conducted in a single hospital in southern Poland between 2017 and 2024, excluding 2020-2021 due to the COVID-19 pandemic. HAI surveillance followed the ECDC HAI-Net methodology. The study included all hospitalized patients in wards where invasive medical devices or invasive procedures were used. The intervention consisted of expanding the IPCT, increasing managerial support, extending infection control nurses' competencies, and implementing routine ICP medical consultations. Changes in HAI incidence rates between the pre-intervention (pre-IP) and post-intervention (post-IP) periods were analyzed for catheter-associated urinary tract infections (CAUTI), ventilator-associated pneumonia (VAP), and central line-associated bloodstream infections (CLABSI), expressed per 1000 device-days. Results: The overall device utilization increased from 0.44 to 0.54 per 1000 patient-days in the post-IP period. The utilization of microbiological diagnostic tests more than doubled, with marked increases in blood cultures (6.4% vs. 15.5%) and urine cultures (7.7% vs. 11.0%). No IPCT consultations occurred in the pre-IP period, while 874 consultations were recorded in the post-IP period. Th incidence rates for CAUTI and VAP increased (1.4 to 3.1 and 11.7 to 24.6 per 1000 device-days, respectively). The CLABSI incidence showed no significant overall change. Conclusions: Structural and functional changes in the IPCT, combined with the introduction of ICP consultations, substantially enhanced the quality and completeness of HAI surveillance in the analyzed hospital. The findings highlight the importance of leadership-driven engagement in improving infection prevention and control systems.