The expanding role of the hospital epidemiologist in 2014: a survey of the Society for Hospital Epidemiology of America (SHEA) Research Network

• Published in: Infection control and hospital epidemiology Vol. 36; no. 5; pp. 605 - 608
• Main Authors: Morgan, Daniel J, Deloney, Valerie M, Bartlett, Allison, Boruchoff, Susan E, Camagros Couto, Renato, Oji, Michael, Poojary, Aruna, Rogers, Gwen, Sulis, Carol, Milstone, Aaron M
• Format: Journal Article
• Language: English
• Published: United States Cambridge University Press 01-05-2015
• Subjects: Antibiotic resistance; Antibiotics; Bacteria; Catheters; Cross Infection - epidemiology; Cross Infection - prevention & control; Epidemiology; Hospitals; Humans; Hydrogen peroxide; Immunization; Influenza; Medical instruments; Nursing; Pharmacists; Physician's Role; Pneumonia; Population Surveillance - methods; Prevention; Public health; Societies, Medical - statistics & numerical data; Staphylococcus infections; Surveillance; Surveys and Questionnaires; United States; Urinary tract diseases; Urinary tract infections; Urogenital system; Ventilators; United States; United States > US
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1017/ice.2015.11

Information on size of hospital was reported by 52 respondents (of which 27 hospitals had <440 beds) and on community versus teaching hospital was reported by 49 respondents (of which 6 were community hospitals) (Table 1).TABLE 1 Types of Surveillance, Infection Prevention Practices, and Hospital Epidemiologists’ Use of Time and Resources in 2013 and Expectations for 2014 Compared to 2013 Demands on Hospital Epidemiology Using Practice in 2013, % (N/total) Hospitals Expecting Increases in 2014, % (N/total) Hospitals Expecting Decreases in 2014, % (N/total) Active surveillance for MDROs Methicillin-resistant Staphylococcus aureus (MRSA) 90 (55/61) 10.4 (7/67) 3.0 (2/67) Vancomycin-resistant enterococcus (VRE) 59 (33/61) 9.1 (6/66) 9.1 (6/66) Gram-negative MDROs 46 (28/61) 28.8 (19/66) 3.0 (2/66) Surveillance for device-related infections Central line-associated bloodstream infection (CLABSI) 96 (65/68) 11.8 (8/68) 2.9 (2/68) Ventilator-associated pneumonia (VAP) 74 (50/68) 8.1 (5/62) 24.2 (15/62) Ventilator-associated event (VAE) 53 (36/68) 32.3 (20/62) 3.2 (2/62) Catheter-associated urinary tract infection (CAUTI) 93 (63/68) 23.5 (16/68) 2.9 (2/68) Surveillance for SSIs 95 (64/68) 22.7 (15/66) 0.0 (0/66) Chlorhexidine bathing 72 (50/69) 45.6 (31/68) 8.8 (6/68) Monitoring of environmental cleaning 80 (55/69) 61.8 (42/68) 4.4 (3/68) Antimicrobial stewardship 85 (57/67) 54.5 (36/66) 4.5 (3/66) Support and Use of Time Hospitals Expecting Increases in 2014, % (N/total) Hospitals expecting decreases in 2014, % (N/total) Program reporting requirements 58.8 (40/68) 14.7 (10/68) Overall program responsibilities 57.4 (39/68) 11.8 (8/68) No.of infection preventionists 13.4 (9/67) 6.0 (4/67) Financial support for hospital epidemiologist 12.8 (6/47) 6.4 (3/47) Research on infection prevention 26.5 (13/49) 6.1 (3/49) Time devoted to meetings 30.8 (21/68) 8.8 (6/68) Time devoted to frontline staff (eg, rounds, education) 29.4 (20/68) 14.7 (10/68) Active surveillance culturing for MDROs was common among respondents in 2013. Notable differences between US and non-US participants included active surveillance for Gram-negative bacteria (37% in the United States vs 72% outside the United States), monitoring of environmental cleaning (88% in the United States vs 65% outside the United States), antimicrobial stewardship programs (92% in the United States vs 72% outside the United States), and presence of a mandatory influenza immunization program (69% in the United States vs 15% outside the United States). The most significant increase in active surveillance is for Gram-negative MDROs, which may be due to the Centers for Disease Control and Prevention (CDC)’s guidance for control of carbapenem-resistant Enterobacteriaceae (CRE) in 2012.6 Hospitals reported an increase in multiple-infection prevention strategies including chlorhexidine gluconate (CHG) bathing.