Infection control resources in Iowa

Background: The duties of infection control professionals (ICPs) have increased over time, but resources have not increased substantially. Numerous states have passed or have considered mandatory reporting laws for health care-associated infections. Such laws would increase lCPs' work further. Methods: We conducted two surveys of ICPs in Iowa to determine their current responsibilities and resources and to estimate the resources they would need if they were required to report all nosocomial infections to the state. Results: Most hospitals had less than I full time equivalent performing infection control (mean = 0.64). Many respondents had several roles within the hospital. Surveillance methods and scope varied by hospital size. Most ICPs did not use catheter days as the denominator for rates of bloodstream infections. Over 50% of Iowa's hospitals are critical access hospitals, most of which did not have intensive care units, and most had very few patients with central venous catheters. Conclusions: Hospitals in Iowa have limited resources for infection control. One size fits all public reporting systems are not appropriate for states like Iowa that have a few large hospitals and many small hospitals.