Recruitment and hiring practices in United States infection prevention and control departments: Results of a national survey

Development, delivery, and evaluation of the Texas Epidemic Public Health Institute pilot infection control lecture series

Introduction

The Texas Epidemic Public Health Institute (TEPHI) aims to keep Texans healthy and the economy strong by preparing for the next infectious disease outbreak. TEPHI's Small Rural Healthcare Preparedness core developed, delivered, and evaluated a pilot infection prevention and control webinar series called Infection Control for rural-serving health professionals and organizations based on infection prevention and control field best practices.

Methods

Data from the first year of the Infection Control series was collected through attendee registration forms, attendance records, knowledge, and post-lecture evaluation surveys using Qualtrics. The data were analyzed using Qualtrics software. Lectures were free and open to the public across disciplines. The material was promoted through public health channels with promotional flyers.

Results

1,105 individuals attended or viewed the Infection Control series. Despite a generally low response rate to evaluation surveys, feedback was consistently positive. Participants noted a "high likelihood of future TEPHI infection prevention and control lecture attendance." The feedback informed improvements for the second year of the series.

Conclusion

Attendees of the Infection Control series gained a deeper understanding of relevant policies, procedures, and practices. By providing essential, accessible education on infection prevention and control at no cost, healthcare systems, administrators, and providers in rural healthcare systems across Texas have acquired the necessary knowledge to establish and maintain a safe environment for patients and staff in healthcare settings.

Evaluation of Certification Board of Infection Control and Epidemiology, Inc Certification in Infection Control (CIC) examination rates

BACKGROUND

Infection prevention professionals develop through training and certification practices, with the Certified in Infection Control and Epidemiology (CIC) exam being the industry standard for infection prevention and control expertise.

METHODS

This study conducted a secondary analysis of Certification Board of Infection Control and Epidemiology, Inc exam scores from 2013 to 2022. Reliability coefficients, Spearman-Brown coefficients, and Standard Error Measurement averages were calculated for the CIC exam's eight objective areas from 2016 to 2022.

RESULTS

Over the past decade, pass rates varied from 57.30% to 85.40%, with a mean of 69.7%. The number of exam participants ranged from 574 to 1,392. Despite the variability, the highest reliability, Spearman-Brown, and Standard Error Measurement averages were consistently observed in areas such as identifying infectious disease processes, surveillance, epidemiological investigation, and controlling transmission of infectious agents.

CONCLUSIONS

As more facilities push for certification, the number of CIC exam takers has increased. However, the evolving nature of infection prevention and the lack of a standardized training track contribute to variations in reliability coefficients across the exam's objective areas.

Human resource management to assist infection prevention and control professionals: a scoping review

Infection prevention and control (IPC) professionals are key intermediaries between hospital managers and frontline staff. During the novel coronavirus disease pandemic, IPC professionals faced new challenges. Unfortunately, research on human resource management (HRM) to support IPC during and between pandemics is lacking. Therefore, this scoping review aimed to elucidate the existing knowledge on HRM measures in this context and thus contribute to the pandemic preparedness of healthcare facilities. It was conducted as part of the "PREparedness and PAndemic REsponse in Germany (PREPARED)" project within the Network University Medicine (NUM), using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. PubMed was searched without time restriction until 2023 (filter: English, German). Two reviewers assessed titles/abstracts and full texts, respectively. A total of nine publications were included, eight of which were published in the USA. All publications reported survey data (quantitative: six). Measures targeting personnel development and the qualification of IPC personnel were reported in six studies, i.e., almost two-thirds of the studies, of which five focused on the tasks of IPC professionals. In contrast, management of personnel costs and remuneration systems were reported less frequently (three studies), and only regarding issues around retention, compensation and dismissal. In conclusion, research gaps include trials on implementation and effectiveness of HRM for IPC. Given the increasing shortage of IPC professionals, HRM measures during and between pandemics become more important for establishing pandemic preparedness.

Assisting the infection preventionist: Use of artificial intelligence for health care-associated infection surveillance

BACKGROUND

Health care-associated infection (HAI) surveillance is vital for safety in health care settings. It helps identify infection risk factors, enhancing patient safety and quality improvement. However, HAI surveillance is complex, demanding specialized knowledge and resources. This study investigates the use of artificial intelligence (AI), particularly generative large language models, to improve HAI surveillance.

METHODS

We assessed 2 AI agents, OpenAI's chatGPT plus (GPT-4) and a Mixtral 8×7b-based local model, for their ability to identify Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) from 6 National Health Care Safety Network training scenarios. The complexity of these scenarios was analyzed, and responses were matched against expert opinions.

RESULTS

Both AI models accurately identified CLABSI and CAUTI in all scenarios when given clear prompts. Challenges appeared with ambiguous prompts including Arabic numeral dates, abbreviations, and special characters, causing occasional inaccuracies in repeated tests.

DISCUSSION

The study demonstrates AI's potential in accurately identifying HAIs like CLABSI and CAUTI. Clear, specific prompts are crucial for reliable AI responses, highlighting the need for human oversight in AI-assisted HAI surveillance.

CONCLUSIONS

AI shows promise in enhancing HAI surveillance, potentially streamlining tasks, and freeing health care staff for patient-focused activities. Effective AI use requires user education and ongoing AI model refinement.

Revitalizing the infection prevention workforce with a fellowship program for underrepresented groups

Infection preventionist (IP) positions are difficult to fill, and future workforce shortages are anticipated. The IP field has less racial and ethnic diversity than the general nursing workforce or patient population. A targeted fellowship program for underrepresented groups allowed the recruitment and training of IPs while avoiding staffing shortages.

Strategies to Address COVID-19 Vaccine Hesitancy Among Ohio Nursing Home Staff

BACKGROUND AND OBJECTIVES

Despite federal legislation requiring nursing home (NH) staff members to be vaccinated against coronavirus disease 2019 (COVID-19), unvaccinated staff pose an ongoing public health risk. The research question guiding this study is as follows: What is the relationship between strategies to address vaccine hesitancy and vaccination rates among staff? We used the diffusion of innovation (DOI) theory as a theoretical framework.

RESEARCH DESIGN AND METHODS

The sample (N = 627) included Ohio-based NHs. Using national and state NH data, multivariable linear regression techniques demonstrated the relationship between strategies to address vaccine hesitancy and vaccination rates among NH staff.

RESULTS

Peer counseling and providing sick time or time off for vaccine symptoms were both statistically significant strategies. Compared to facilities that did not engage in peer counseling, those that did saw an average increase of 3.2% of their staff vaccinated. Those that provided sick time or time off saw an average increase of 3.9% of their staff vaccinated. There was no statistically significant relationship between hiring full- or part-time facility infection preventionists and vaccination rates.

DISCUSSION AND IMPLICATIONS

In order to foster vaccine confidence among long-term services staff, peer counseling, and providing sick time or time off are examples of strategies that can affect vaccination rates among staff. According to DOI, these strategies target the communication channels and social systems of an organization. While this study focuses on NHs, results remain critically important to the remainder of the long-term services system, which does not have vaccine requirements similar to the NH industry.

Impacts of the COVID-19 pandemic on the infection prevention and control field: Findings from focus groups conducted with association for professionals in infection control & epidemiology (APIC) members in fall 2021

INTRODUCTION

Emergence of the Delta variant in 2021 changed the pandemic landscape and led to healthcare surges across the US, despite availability of COVID-19 vaccine. Anecdotal information indicated that the infection prevention and control (IPC) field was changing, but formal assessment was needed.

METHODS

Focus groups (6) were conducted with APIC members in November and December, 2021 to elicit infection preventionists' (IP) opinions changes to the IPC field due to the pandemic. Focus groups were audio recorded via Zoom and transcribed. Content analysis was used to identify major themes.

RESULTS

Ninety IPs participated. IPs described multiple changes to the IPC field during the pandemic, including being more involved in policy development, the challenge of transitioning back to routine IPC while still responding to COVID-19, increased need for IPs across practice settings, difficulties in recruiting and retaining IPs, presenteeism in healthcare, and extensive burnout. Participants suggested approaches to improve IPs' wellbeing.

CONCLUSIONS

The ongoing pandemic has brought significant changes to the IPC field, including a shortage of IPs just as the field is expanding rapidly. The continued overwhelming workload and stress due to the pandemic has resulted in burnout among IPs and the need for initiatives to improve their wellbeing.

Associations among infection prevention professionals' mental/physical health, lifestyle behaviors, shift length, race, and workplace wellness support during COVID-19

BACKGROUND

COVID-19 added stress to infection prevention professionals' (IPs) work-life that may have impacted their well-being. This study aimed to describe IPs' mental and physical health and lifestyle behaviors during the pandemic and their associations with IP role, perceived worksite wellness support, shift length, and race and/or ethnicity.

METHODS

A random sample of Association for Professionals in Infection Control and Epidemiology members (6,000) were emailed a survey assessing mental and physical well-being, lifestyle behaviors, and perceived worksite wellness support.

RESULTS

A total of 926 IPs responded (15% response rate). Few met guidelines for sleep (34.1%), physical activity (18.8%), and fruit and vegetable consumption (7.3%). Rates of depression, anxiety, and burnout were 21.5%, 29.8%, and 65%. Front line and practicing IPs and IP administrators and directors had more negative mental health impacts than IPs in other roles. IPs with organizational wellness support were less likely to report negative COVID-19 impacts. IPs working 9-11+ hours/day were more likely to report worsening physical and mental health due to COVID-19. There were no significant differences in odds of negative COVID-19 impacts on lifestyle behaviors between white and racial and ethnically diverse IPs.

CONCLUSIONS

IPs who worked shorter shifts and had more organizational wellness support had better well-being outcomes. Organizations must fix system issues that result in poor health and invest in workforce wellness.

A Qualitative Descriptive Study of Nurse Manager Decision-Making Associated With RN Hiring

OBJECTIVE

To explore the practices and self-confidence of nurse manager (NM) decision-making related to evaluating RN hiring needs.

BACKGROUND

Evidence-based hiring strategies to sustain workforce stability were identified as a gap in the literature. Locally, inconsistencies in the method that NMs use to determine how many RNs to hire and at what frequency to hire them were observed, posing a threat to strategic workforce planning.

METHODS

Using a mixed-methods, qualitative descriptive design, researchers used in-depth interviews and surveys to assess current practices and NM confidence related to evaluating hiring needs.

RESULTS

The overarching theme among the 10 participants was false confidence. Subthemes reflected the dissonance in confidence and high variability in the hiring process. NM stress, time spent, and confidence were not correlated with years' experience.

CONCLUSIONS

NMs experience stress, spend excessive time, and use varying approaches to evaluate hiring needs. Years of managerial experience are unrelated to practical skills or level of confidence in hiring decision-making.

Challenges and opportunities in recruiting, hiring and training infection preventionists across facility settings

BACKGROUND

Recruitment of skilled professionals for the infection preventionist (IP) role is an ongoing priority for organizations. The objective of this study was to understand differences in recruitment, hiring and training by facility setting and discuss targeted strategies for diverse organizations.

METHODS

A survey study investigated recruitment, hiring and training practices for IPs and stratified by facility location (multi-location health system (MLHS), urban, suburban and rural), specifically pertaining to job description requirements, background of candidates interviewed and hired and training programs.

RESULTS

A Master's in Public Health degree was significantly more frequently listed on MLHS and urban facility job descriptions (37.3%, 43.7%, respectively) than suburban (27.4%) and rural facility job descriptions (17.2%)(P < .01). Respondents from MLHS (41.3%), urban facilities (47.0%), suburban facilities (41.7%) were more likely to interview public health professionals than rural facilities (20.3%, P = .003). Respondents from MLHS, (73.3%), urban (68.4%), and suburban (62.2%) facilities were significantly more likely to use local Association for Professionals in Infection Control and Epidemiology chapter for training compared to rural facilities (32.4%)(P < .001).

CONCLUSIONS

Our results identified differences in facility setting with recruitment, hiring and training practices. Optimizing recruitment and training best practices will result in a large and well trained IP workforce and patient safety.

Infection preventionist retention and professional development strategies: Insights from a national survey

This brief report explores why Infection Preventionists (IPs) leave their positions and strategies implemented to retain and professionally develop IPs. National survey data of over 500 APIC members found turnover is due to personal reasons, professional advancement opportunities and work-life balance challenges. In addition, IPs are retiring in great numbers. The creation of career pathways and providing an environment that supports work-life balance are novel strategies that could retain and professionally develop IPs.