We're All Resource Limited Now.....
Every year at our annual SHEA meeting we have at least one session on infection control in “resource-limited” settings, by which we’ve generally meant developing countries or other areas with severe financial, social, infrastructure or other challenges to good infection control practice. The global economic slowdown, however, has put new financial pressures on almost every hospital—certainly not close to those in developing country settings, but still significant. The challenge is to respond to these financial pressures without compromising patient safety, but I’m afraid we may not fully appreciate the risks involved.
While most of us are concerned first with adequate staffing of our infection control programs, hiring freezes and personnel shortages in other areas will probably have greater consequences for infection prevention. Three obvious areas are in nursing, housekeeping, and clinical laboratory support. The literature linking nurse-patient ratios to infection risk is convincing, data keep accumulating about the critical role of environmental disinfection in infection prevention, and our labs serve as the most important source of surveillance data to guide prevention efforts.
So we are at risk for a double (triple? quadruple?) whammy—loss of capacity to monitor outcomes and processes of care, and the loss of front line personnel who are so important to infection prevention. We need to be at the table during these discussions, to help hospital administrators make difficult budgetary decisions without compromising patient safety.
While most of us are concerned first with adequate staffing of our infection control programs, hiring freezes and personnel shortages in other areas will probably have greater consequences for infection prevention. Three obvious areas are in nursing, housekeeping, and clinical laboratory support. The literature linking nurse-patient ratios to infection risk is convincing, data keep accumulating about the critical role of environmental disinfection in infection prevention, and our labs serve as the most important source of surveillance data to guide prevention efforts.
So we are at risk for a double (triple? quadruple?) whammy—loss of capacity to monitor outcomes and processes of care, and the loss of front line personnel who are so important to infection prevention. We need to be at the table during these discussions, to help hospital administrators make difficult budgetary decisions without compromising patient safety.
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