Infection control teams are facing the biggest disruption the field has seen in years.
Thanks to the evolving COVID-19 pandemic, shifting care models and an aging population, infection prevention and control (IPC) leaders will need to rethink and refresh the way they approach risk assessment going forward.
The specifics of your IPC risk assessment — a detailed review of potential risk factors for infection related to the care and services you provide — will vary depending on your goals and risk profile. Focusing on SMART (Specific, Measurable, Actionable, Realistic, Timely) elements will help ensure a solid foundation as you customize your risk assessment and infection control plan.
1. Specific: Create a detailed list of infection risks and challenges
From outbreaks of specific pathogens to your most common services, your IPC risk assessment should be shaped by your unique environment and goals. Here are a few factors to consider.
Geographic location
Infection risk can vary significantly by region. For example, Oregon had its first outbreak of three cases of the drug-resistant fungus Candida auris in late 2021; by that time, California, Illinois, New York and Florida had all had over 100 cases in a one-year period, the CDC reports.
Population served and surrounding community
Patient demographics will also shape your risk assessment. Older patients, for example, have more contact with long-term care facilities where respiratory tract and gastrointestinal infections are common, notes research from Epidemiology and Infection.
Employee management and staff education
All staff must be updated on the latest infection control policies and current risks to effectively support your program.
Environment of care and cleaning procedures
Your physical environment, plus your cleaning, disinfection, and sterilization practices, will also shape your IPC program. For example, many newer facilities incorporate evidence-based design to support and enhance infection control outcomes. Additionally, your level of investment in practices like antimicrobial stewardship will have a direct impact on your risk assessment.
Emergency preparedness
The COVID-19 pandemic has stress-tested emergency management plans across the country. Volume surges and the risk of disease transmission have highlighted the important role that these plans play in successful infection control.
Risk of infections
Depending on your service lines, population mix, and supplies used, your overall and patient-specific risk of infection will change. These risks can include:
- Procedure-associated risks
- Device-associated risks
- Emerging or multidrug-resistant organisms
- Enteric diseases
- Respiratory diseases
2. Measurable: Make use of data
The data you collect from clinical surveillance is one of the most powerful tools you have in infection control risk assessment. For example, if your antibiogram reveals increased resistance patterns for commonly seen organisms, your assessment should address this discovery.
One highly useful tool in assessing program effectiveness is the CDC’s Targeted Assessment for Prevention Strategy (TAP). TAP is a quality improvement framework that works by:
- Supporting hospital-acquired infection (HAI) prevention and reduction
- Targeting locations with excess HAIs and implementing interventions
- Identifying gaps in prevention and opportunities for improvement, which serve as real-time teaching moments for multidisciplinary staff
However, manually aggregating data from disparate sources such as antibiograms and TAP can be a daunting and time-consuming task. All this information can be streamlined through use of an electronic clinical surveillance solution. While your staff focus on consultation and education, clinical surveillance can:
- Automatically identify potential or actual HAIs
- Aggregate and analyze infection prevention data (including risk-adjusted Standardized Infection Ratios (SIRs)
- Streamline daily surveillance workflows
Budgeting your time for analysis and patient care is critical in the face of the ongoing COVID-19 pandemic.
3. Actionable: Rank threats based on impact and probability
Action starts with risk stratification. As healthcare budgets are increasingly strained, more infection preventionists are being challenged by limited resources.
As you develop your risk assessment, make a habit of examining one threat at a time, judging the potential impact and probability as you rank its severity.
4. Realistic: Ask your staff for suggestions
Realistic goals are rooted in people: Ask for input from the staff closest to the problems. Accrediting agencies often don’t give specific instructions for this step, which means you have the freedom to include as much staff input as possible as you build your risk assessment.
This assessment can take the form of surveys (like this one for nursing homes from the Joint Commission), committee participation and interviews. Include members of the infection prevention team, nurses, other clinicians, IT, and organizational leadership.
5. Timely: Assess infection prevention programs annually
Your risk assessments should be performed annually, and possibly more frequently if your findings warrant it.
Ongoing review is critical to IPC program success. Regular check-ins help you identify high-risk patients early, reduce the incidence of HAIs and strengthen your antimicrobial stewardship practices to improve patient care and safety. Your team’s multidisciplinary approach combined with the right technology and metrics will make your IPC program more effective and efficient, benefiting patients, visitors, staff and your entire care community.
To get ahead of scheduling difficulties, consider the following best practices curated by our experienced infection prevention team:
- Don’t push the date past its deadline.
- Begin assessment earlier than the deadline to avoid citation for lateness.
- Note events during the year that might significantly affect your assessment and that could trigger a revision.
As you build out your infection control plan and risk assessment goals, begin with taking time to assess your facility and staff. And if you’re looking for a starting point as you create those goals, we recommend you start with an eye on these 5 attributes of high-performing infection prevention and control programs.
