Healthcare-associated infections (HAIs) remain one of the most persistent and preventable threats to patient safety. On any given day in the U.S., one in 31 patients will contract an HAI, leading to approximately 687,000 infections and 72,000 deaths annually. These infections – caused by drug-resistant bacteria, surgical complications, bloodstream infections, and device-associated pathogens – not only place patients at serious risk of harm but also burden the healthcare system with an estimated $28 billion annually in direct medical costs and an additional $12 billion in lost productivity and indirect expenses, all of which are largely preventable. (APIC) and our 15,000 infection preventionist (IP) members are dedicated to protecting patients, visitors, and healthcare workers from HAIs, enhancing preparedness for emerging infectious disease threats, and driving cost-saving measures for hospitals, nursing homes, and ambulatory centers nationwide.

The Centers for Disease Control and Prevention’s NHSN is the gold standard for the collection of HAI data, having been developed with input from infection prevention experts over decades.  In addition to allowing healthcare facilities to evaluate their progress toward national goals for the reduction of HAIs based on a common set of definitions, NHSN reporting allows for seamless data sharing from healthcare facilities to both CDC and the Centers for Medicare & Medicaid Services (CMS). This means the data can be utilized for CMS quality improvement programs while providing clinicians and state/local public health officials with critical answers regarding the prevalence of deadly infections at the national, state, and local levels.

This system is used by an estimated 38,000 healthcare facilities annually – including nearly all hospitals, nursing homes, dialysis facilities, and ambulatory surgery centers — and is highly adaptable for use during public health emergencies. NHSN saves lives by preventing tens of thousands of infections through reliable, actionable data.

Advancement in medical device development has greatly transformed medical care, but complex and unclear cleaning, disinfection, and sterilization instructions create unnecessary burdens and increase infection risks. While the FDA requires manufacturers to include instructions for use (IFUs), there are no standards ensuring they are clear, accessible, or realistically implementable. As a result, hospitals are often cited for failure to follow confusing or impractical IFUs, despite their best efforts.

Currently, nearly half of healthcare facilities report having been cited for failing to properly follow poorly written IFUs. Furthermore, 84% of IPs have had to contact manufacturers for clarification because of unclear or inconsistent instructions.

APIC supports reforms that require IFUs to be evidence-based, easily understood and practical for implementation. Standardizing clear, implementable instructions will improve patient safety and reduce administrative burden.

The COVID-19 pandemic had devastating consequences in nursing homes, demonstrating the critical importance of robust infection prevention and control practices to protect residents from COVID-19 and other infectious diseases. As the Government Accountability Office (GAO) pointed out in March 2023, “A growing body of work shows that COVID-19 exposed and worsened long-standing infection prevention and control problems in nursing homes and indicates there are opportunities for HHS to evaluate and prioritize efforts to bolster infection prevention and control.”

Under President George W. Bush, HHS introduced mandatory reporting of HAIs and infection reduction targets for hospitals, resulting in significant declines in preventable infections and cost savings.  Similar efforts must be implemented in nursing homes to help target evidence-based infection reduction strategies in these settings, where residents are among the most vulnerable to HAIs.

A strong and well-supported IPC workforce is essential for patient safety and public health resilience. An APIC survey in 2020 showed that 40% of the IPC workforce will enter retirement age in the next decade, exacerbating an already strained pipeline of experts.

Even prior to the COVID-19 pandemic, which dramatically increased demand for infection prevention and control services, there were already concerns about the capacity of the IP workforce. Twenty-five percent of hospitals listed at least one IP vacancy, and more than half of long-term care facilities experienced an IP leaving their position within the previous 24 months, highlighting serious workforce retention challenges. Without immediate investment in recruitment, training, and retention, the IPC workforce will struggle to meet CMS-mandated infection prevention requirements and protect patients from preventable harm.