Determining Infection Prevention Staffing for Pediatric Ambulatory and Procedural Setting

Abstract

Background Since 2002, the recommended staffing levels for infection prevention and control (IPC) departments has been one full-time equivalent (FTE) per 100 occupied inpatient beds (O'Boyle et al., 2002). However, analyses by Bartles et al. (2018) suggest that this ratio should be one FTE per 69 beds, after accounting for facility/system complexity. With ambulatory utilization rising across the healthcare sector, accounting for these locations in infection preventionist (IP) staffing models is becoming increasingly important. With our pediatric enterprise's expanding ambulatory footprint, we sought to understand the complexity of our outpatient operations and assess the IPC staffing needed to support these locations/services. Methods This needs assessment applied the tool developed by Bartles et al. for their 2018 staffing analysis. Ambulatory and procedural areas on the main campus and 11 satellite/affiliated locations were surveyed for clinic complexity indicators. We obtained total IP hours/week dedicated to ambulatory/procedural locations by summing the estimated number of hours/week IPs spent engaged in rounding, offsite tasks, and education. IP hours spent on education were estimated as 30% of the total IP hours/week dedicated to rounding and offsite tasks. Results From our review, the institution's ambulatory and procedural locations represent 238 unique locations/services. The most common indicators of clinic complexity included performing surgical procedures (20.6%) and aerosol-generating procedures (31.9%). Moreover, an estimated 178 IP hours/week were dedicated to these locations, of which 43.8% consisted of providing consultative services. These hours equate to 4.4 FTEs required for our ambulatory and procedural areas. Conclusions Without accounting for future state operations, this analysis showed that our department would benefit from 2.4 additional FTEs to support our ambulatory/procedural operations. Assessing the complexity and scope of pediatric ambulatory/procedural locations is a valuable tool for (1) assessing IP staffing needs and (2) for determining whether there is an appropriate distribution of IP time and resources in such locations. Since 2002, the recommended staffing levels for infection prevention and control (IPC) departments has been one full-time equivalent (FTE) per 100 occupied inpatient beds (O'Boyle et al., 2002). However, analyses by Bartles et al. (2018) suggest that this ratio should be one FTE per 69 beds, after accounting for facility/system complexity. With ambulatory utilization rising across the healthcare sector, accounting for these locations in infection preventionist (IP) staffing models is becoming increasingly important. With our pediatric enterprise's expanding ambulatory footprint, we sought to understand the complexity of our outpatient operations and assess the IPC staffing needed to support these locations/services. This needs assessment applied the tool developed by Bartles et al. for their 2018 staffing analysis. Ambulatory and procedural areas on the main campus and 11 satellite/affiliated locations were surveyed for clinic complexity indicators. We obtained total IP hours/week dedicated to ambulatory/procedural locations by summing the estimated number of hours/week IPs spent engaged in rounding, offsite tasks, and education. IP hours spent on education were estimated as 30% of the total IP hours/week dedicated to rounding and offsite tasks. From our review, the institution's ambulatory and procedural locations represent 238 unique locations/services. The most common indicators of clinic complexity included performing surgical procedures (20.6%) and aerosol-generating procedures (31.9%). Moreover, an estimated 178 IP hours/week were dedicated to these locations, of which 43.8% consisted of providing consultative services. These hours equate to 4.4 FTEs required for our ambulatory and procedural areas. Without accounting for future state operations, this analysis showed that our department would benefit from 2.4 additional FTEs to support our ambulatory/procedural operations. Assessing the complexity and scope of pediatric ambulatory/procedural locations is a valuable tool for (1) assessing IP staffing needs and (2) for determining whether there is an appropriate distribution of IP time and resources in such locations.