Results published in AJIC demonstrate need for HIT-specific training resources to improve infection prevention efforts in rapidly growing healthcare space

Arlington, Va., January 12, 2023 – A study published today in the American Journal of Infection Control (AJIC) reveals that many home infusion therapy (HIT) staff receive no formal training on how to perform central line-associated bloodstream infection (CLABSI) surveillance. The study, conducted by researchers from Johns Hopkins University, also identified specific training barriers that should be addressed to improve infection surveillance in this rapidly growing healthcare space.

“There was a 300% increase in patients receiving HIT in the United States between 2008 and 2019, and many of these individuals are at risk for CLABSI,” said Sara C. Keller MD, MSHP, MPH,Johns Hopkins University School of Medicine, and an author on the published study. “Appropriate, accurate CLABSI surveillance to understand rates in the HIT setting is necessary to drive prevention efforts.”

Infection prevention and surveillance training approaches have not been well defined in the HIT setting. Additionally, most HIT agencies do not employ dedicated, trained infection preventionists or devote sufficient resources to CLABSI surveillance activities, due in part to lack of funds and lack of mandated reporting of healthcare-associated infections (HAIs) in HIT. 

HIT involves the administration of medicines through a catheter. CLABSIs are serious infections that can occur when bacteria enter the bloodstream through central line catheters. According to the CDC, of patients who get a bloodstream infection from having a central line, up to 1 in 4 may die. 

Keller and colleagues conducted qualitative interviews with 21 home infusion staff from five large HIT agencies covering 13 states and Washington, DC. Questions posed to the staff – all of whom perform surveillance activities – focused on their surveillance training, barriers to and facilitators for CLABSI surveillance, and barriers to training in CLABSI surveillance. 

Researchers found that many HIT staff who perform surveillance received no formal training on CLABSI surveillance. Study participants described instead a range of informal training experiences that included learning on the job (even from similarly untrained co-workers), relying on prior experience, and attending conferences. Participants also highlighted three primary barriers to HIT CLABSI surveillance training: Lack of learning resources such as user-friendly toolkits that accommodate high workload and time pressures; lack of awareness of professional development resources available to them; and lack of formal training provided by their respective organizations.

“These findings illustrate that there is a great need for infection prevention personnel and expertise in HIT,” said Patricia Jackson, RN, BSN, CIC, FAPIC, 2023 APIC president. “This information should prompt a concerted effort to implement formal infection prevention and surveillance training for HIT staff, including the development and deployment of training tools specific to the HIT setting.” 

About APIC

Founded in 1972, the Association for Professionals in Infection Control and Epidemiology (APIC) is the leading association for infection preventionists and epidemiologists. With more than 15,000 members, APIC advances the science and practice of infection prevention and control. APIC carries out its mission through research, advocacy, and patient safety; education, credentialing, and certification; and fostering development of the infection prevention and control workforce of the future. Together with our members and partners, we are working toward a safer world through the prevention of infection. Join us and learn more at apic.org. 

About AJIC

As the official peer-reviewed journal of APIC, The American Journal of Infection Control(AJIC) is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. Published by Elsevier, AJIC also publishes infection control guidelines from APIC and the CDC. AJIC is included in Index Medicus and CINAHL. Visit AJIC at ajicjournal.org. 

NOTE FOR EDITORS

“The Need to Expand the Infection Prevention Workforce in Home Infusion Therapy,” by Sara Keller, MD, MSHP, MPH; Opeyemi Oladapo-Shittu, MD, MPH, CPH; Susan M. Hannum, PhD; Alejandra B.

Salinas, BS; Kimberly Weems, MPH; Jill Marsteller, PhD; Ayse P Gurses, PhD, MPH, MS; Sara E. Cosgrove, MD, MS was published online in AJIC on January 12, 2023. The article may be found at:

https://doi.org/10.1016/j.ajic.2022.11.008

AUTHORS

Sara C. Keller, MD, MSHP, MPH (corresponding author: skeller9@jhmi.edu)

Johns Hopkins University School of Medicine, Johns Hopkins Bloomberg School of Public Health Baltimore, MD, USA

Opeyemi Oladapo-Shittu, MBBS, MPH, CPH

Johns Hopkins University School of Medicine

Baltimore, MD, USA

Susan M. Hannum, PhD

Johns Hopkins Bloomberg School of Public Health

Baltimore, MD, USA

Alejandra B. Salinas, BS

Johns Hopkins University School of Medicine

Baltimore, MD, USA

Kimberly Weems, MPH Johns Hopkins Hospital

Baltimore, MD, USA

Jill Marsteller, PhD

Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University School of Medicine Baltimore, MD, USA

Ayse P Gurses, PhD, MPH, MS

Johns Hopkins University School of Medicine

Baltimore, MD, USA

Sara E. Cosgrove, MD, MS

Johns Hopkins University School of Medicine, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Hospital

Baltimore, MD, USA