Infection Prevention in the Hospital from Past to Present: Evolving Roles and Shifting Priorities
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Hospital epidemiologists are vital components of integrated health centers. This central place in the healthcare landscape has rapidly evolved over a half century. Early hospital epidemiologists possessed a visionary focus on patient safety many decades prior to the quality revolution of the 1990s. A systematic and scientific approach to infection prevention has facilitated the evolution of hospital epidemiology, along with advances in technology, and increasing public attention to infectious complications in the hospital. Currently, the growing expansion of tasks and moving regulatory targets strain existing resources. These challenges threaten to limit the effectiveness of some infection-prevention activities, while also providing important opportunities for improving care. It will be increasingly important to advocate for appropriate resources to address a diverse set of changing infection prevention priorities.
KeywordsHospital epidemiology Healthcare-associated infection Infection prevention Infection preventionist Infection control Regulations
Compliance with Ethical Standards
Conflict of Interest
Drs Doll, Hewlett, and Bearman declare they have no conflicts of interests.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 4.National Research Council, Communicable Diseases Center. Section II: summary and recommendations. In: Proceedings of the National Conference on Hospital-Acquired Staphylococcal Disease; Atlanta, Georgia; Sept 15–17, 1958.Google Scholar
- 6.••Haley RW, Shachtman RH. The emergence of infection surveillance and control programs in US hospitals: an assessment, 1976. Am J Epidemiol. 1980;111:574–91. These are the historic SENIC results that provided evidence of the effectiveness of infection prevention programs in decreasing infection rates.PubMedGoogle Scholar
- 9.Center for Disease Control. National Nosocomial Infections Study Annual Summary, 1975. Atlanta, GA: U.S. Department of Health, Education, and Welfare, Health Services and Mental Health Administration; issued October, 1972. HSM 73–8181.Google Scholar
- 11.Thompson RL. Surveillance and reporting of nosocomial infections. In: Wenzel RP, editor. Prevention and control of nosocomial infections. 1st ed. Baltimore: Williams & Wilkins; 1987.Google Scholar
- 12.American Hospital Association Committee on Infections Within Hospitals. Infection control in the hospital. 3rd ed. Chicago: American Hospital Association; 1974.Google Scholar
- 13.Centers for Disease Control. Outline for surveillance and control of nosocomial infections. Atlanta, GA: CDC; 1972. http://stacks.cdc.gov/view/cdc/7697. Accessed February 16th, 2016.
- 19.Association for Practitioners in Infection Control Newsletter, Vol. 1, No. 1, March, 1973. APIC website. http://www.apic.org/Resource_/TinyMceFileManager/History/First_APIC_newsletter_ 1973.pdf. Accessed February 17, 2016.
- 20.Peterson RA. Using the literature. In: Wenzel RP, editor. Prevention and control of nosocomial infections. 1st ed. Baltimore: Williams & Wilkins; 1987.Google Scholar
- 21.•Ranji SR, Shetty K, Posley KA, Lewis R, Sundaram V, Galvin CM, et al. Prevention of healthcare-associated infections. In: Shojania KG, McDonald KM, Wachter RM, Owens DK, editors. Closing the quality gap: a critical analysis of quality improvement strategies. Rockville: Agency for Healthcare Research and Quality; 2007. This is a review of the quality of research in the quality improvement and a call for more robust data; it is applicable to infection prevention research.Google Scholar
- 24.Lohr K, ed. Hospital Conditions of Participation in Medicare. In: Medicare: a strategy for quality assurance, volume 1. Washington, DC: National Academy Press; 1990. http://www.nap.edu/catalog/1547.html. Accessed February 18, 2016.
- 28.Weber SG, Huang SS, Oriola S, et al. Legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci: position statement from the joint SHEA and APIC task force. Infect Control Hosp Epidemiol. 2007;28:249–60.CrossRefPubMedGoogle Scholar
- 37.Marsteller JA, Hsu YJ, Weeks K. Evaluating the impact of mandatory public reporting on participation and performance in a program to reduce central line-associated bloodstream infections: evidence from a national patient safety collaborative. Am J Infect Control. 2014;42:S209–15.CrossRefPubMedGoogle Scholar
- 39.Peasah SK, McKay NL, Harman JS, Al-Amin M, Cook RL. Medicare non-payment of hospital-acquired infections: infection rates three years post implementation. Medicare Medicaid Res Rev. 2013;3. doi: 10.5600/mmrr.003.03.a08.
- 48.Ristuccia PA, Cunha BA. Microbiologic aspects of infection control. In: Wenzel RP, editor. Prevention and control of nosocomial infections. 1st ed. Baltimore: Williams & Wilkins; 1987.Google Scholar
- 51.•Davey P, Brown E, Charani E, et al. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database Syst Rev. 2013;4:CD003543. This describes the improving but still sub-optimal level of evidence to support antimicrobial stewardship programs and practices in hospitals.PubMedGoogle Scholar
- 52.Office of the Press Secretary. The National Action Plan for combating antibiotic-resistant bacteria. The White House. March 27, 2015. Available at http://www.whitehouse.gov/the-press-office/2015/03/27/fact-sheet-obama-administration-releases-national-action-plan-combat-ant . Accessed November 11, 2015.
- 53.The President’s Council of Advisors on Science and Technology. Report to the President on combating antibiotic resistance. Executive Office of the President. September 9, 2014. Available at http://www.whitehouse.gov/administration/eop/ostp/pcast/docsreports. Accessed November 11, 2015.
- 55.Institute of Medicine. Crossing the quality chasm: A new health system for the 21st Century. National Academies Press; 2001. http://www.nap.edu/read/10027/chapter/1. Accessed February 17, 2016.