Impact of certified infection preventionists in acute care settings: A systematic review


      • Studies examining the impact of certification in acute care settings used cross-sectional designs with a quality rating of good to high.
      • CIC status of individual infection preventionists was associated with greater perception of evidence strength for several infection prevention practices.
      • Hospitals hiring certified infection preventionists were more likely to implement certain infection prevention practices.
      • The association between hiring certified infection preventionists and health care associated-infection rates at hospital level was inconsistent.



      Health care-associated infection (HAI) is a common adverse event affecting patient safety. This review aims to (1) establish evidence for the impact of certified infection prevention and control (CIC) specialists on infection prevention and patient safety in acute care settings and (2) summarize study design and statistical modeling used for impact assessment to inform future studies.


      We searched and reviewed full-text, quantitative studies assessing the impact of CIC. The studies used empirical data published in English between January 2000 and April 2021 in PubMed, PsycINFO, and EMBASE. We identified 8 articles for data extraction and analysis. All eight studies used a cross-sectional design and had a quality rating of good to high based on the Johns Hopkins Nursing Evidence-Based Practice rating scales.


      CIC infection preventionists (IPs) may have a stronger understanding than other practitioners of the evidence for certain infection prevention practices and are more likely to recommend implementing them in the hospitals where they work, especially when the lead IP is certified. The association between CIC and HAI rates was inconsistent in our results.

      Discussion and Conclusions

      Further studies are needed to explore the impact of CIC IPs on HAI rates.

      Key Words

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        • Rothschild JM
        • Landrigan CP
        • Cronin JW
        • et al.
        The critical care safety study: the incidence and nature of adverse events and serious medical errors in intensive care.
        Crit Care Med. 2005; 33: 1694-1700
        • Stefl ME.
        To err is human: building a safer health system in 1999.
        Front Health Serv Manage. 2001; 18: 1
        • Encinosa WE
        • Hellinger FJ.
        The impact of medical errors on ninety-day costs and outcomes: an examination of surgical patients.
        Health Serv Res. 2008; 43: 2067-2085
        • Andel C
        • Davidow SL
        • Hollander M
        • Moreno DA.
        The economics of health care quality and medical errors.
        J Health Care Finance. 2012; 39: 39-50
        • Magill SS
        • Edwards JR
        • Bamberg w
        • et al.
        Multistate point-prevalence survey of health care-associated infections.
        N Eng J Med. 2014; 370: 1198-1208
        • Centers for Medicare & Medicaid Services (CMS), Department of Health and Human Services
        Medicare and Medicaid programs; reform of hospital and critical access hospital conditions of participation. Final rule.
        Fed Regist. 2012; 77: 29034-29076
      1. Certification Board of Infection Control and Epidemiology, Inc. Available at: Accessed February 17, 2020.

      2. The infection prevention profession – Preliminary results from the APIC MegaSurvey. Available at: Accessed July 7, 2019

        • Moher D
        • Liberati A
        • Tetzlaff J
        • Altman DG.
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        Int J Surg. 2010; 8: 336-341
        • Donabedian A.
        Evaluating the quality of medical care.
        The Milbank Memorial Fund Quarterly. 1966; 44: 166
        • Newhouse R
        • Dearholt S
        • Poe S
        • Pugh LC
        • White K.
        The Johns Hopkins Nursing Evidence-based Practice Rating Scale.
        The Johns Hopkins Hospital; Johns Hopkins University School of Nursing, Baltimore, MD2005
        • Saint S
        • Greene MT
        • Olmsted RN
        • et al.
        Perceived strength of evidence supporting practices to prevent health care-associated infection: results from a national survey of infection prevention personnel.
        Am J Infect Control. 2013; 41: 100-106
        • Carrico RM
        • Wiemken T
        • Westhusing K
        • Christensen D
        • McKinney WP.
        Health care personnel immunization programs: an assessment of knowledge and practice among infection preventionists in US health care facilities.
        Am J Infect Control. 2013; 41: 581-584
        • Krein SL
        • Hofer TP
        • Kowalski CP
        • et al.
        Use of central venous catheter-related bloodstream infection prevention practices by US hospitals.
        Mayo Clin Proc. 2007; 82: 672-678
        • Krein SL
        • Kowalski CP
        • Damschroder L
        • Forman J
        • Kaufman SR
        • Saint S.
        Preventing ventilator associated pneumonia in the United States: a multicenter mixed-methods study.
        Infect Control Hosp Epidemiol. 2008; 29: 933
        • Pogorzelska M
        • Stone PW
        • Larson EL.
        Wide variation in adoption of screening and infection control interventions for multidrug-resistant organisms: a national study.
        Am J Infect Control. 2012; 40: 696-700
        • Musuuza JS
        • McKinley L
        • Keating JA
        • et al.
        Correlation of prevention practices with rates of health care-associated Clostridioides difficile infection.
        Infect Control Hosp Epidemiol. 2020; 41: 52-58
        • Wright M
        • Sampene E
        • Safdar N.
        The relationship between infection prevention staffing levels, certification, and publicly reported hospital-acquired condition scores.
        Infect Control Hosp Epidemiol. 2017; 38: 1370-1371
        • Pogorzelska M
        • Stone PW
        • Larson EL.
        Certification in infection control matters: impact of infection control department characteristics and policies on rates of multidrug-resistant infections.
        Am J Infect Control. 2012; 40: 96-101
      3. Association for Professionals in Infection Control and Epidemiology (APIC). APIC calls for properly trained infection prevention expertise in all New York State nursing homes. Available at: Accessed June 17, 2022.