Publications

Raveis VH, Conway LJ, Uchida M, Pogorzelska-Maziarz M, Larson EL, Stone PW. (2014). Translating Infection Control Guidelines Into Practice: Implementation Process Within a Health Care Institution. Qualitative Health Research View the full version of the paper

Stone PW, Pogorzelska-Maziarz M, Herzig CTA, Weiner LM, Furuya EY, Dick A, Larson EL. (2014). State of Infection Prevention in US Hospitals Enrolled in the NHSN. AJIC, 42:94-9. View the full version of the paper

Conway L, Pogorzelska M, Larson EL, Stone PW. (2012). Surgical Site Infection Prevention Policies and Adherence in California Hospitals, 2010. ICHE, 33:640-1. View the full version of the paper

Pogorzelska M, Stone PW, Larson EL. (2012). Wide Variation in Adaption of Screening and Infection Control Interventions for Multi-Drug Resistant Infections: A National Study. AJIC, 40:696-700. View the full version of the paper

Conway L, Pogorzelska M, Larson EL, Stone PW. (2012). Prevention of Catheter Associated Urinary Tract Infections: Presence and Implementation of Policies Nationally and In California ICUs. AJIC, 40:705-10. View the full version of the paper

Pogorzelska M, Stone PW, Larson EL. (2012). Certification in Infection Control Matters: Impact of Infection Control Department Characteristics and Policies on Rates of Multi-Drug Resistant Infections. AJIC, 40:96-101. View the full version of the paper

Uchida M, Stone PW, Conway LJ, Pogorzelska M, Larson EL, Raveis V. (2011). Exploring Infection Prevention: Policy Implications from a Qualitative Study. Policy, Politics & Nursing Practice, 12(2):82-89. View the full version of the paper

Stone PW, Pogorzelska M, Graham D, Jia H, Uchida M, Larson EL. (2011). Impact of State and Federal Policies Related to Healthcare Associated Infections in California: A Nursing Sensitive Quality Measure. Policy, Politics & Nursing Practice, 12(2):73-81. View the full version of the paper

Nelson S, Stone PW, Jordan S, Pogorzelska M, Halpin H, Vanneman M, Larson E. (2011). Patient Safety Climate: Variations in Perceptions by Infection Preventionists and Quality Directors. Interdiscip Perspect Infect Dis, doi:10.1155/2011/357121. View the full version of the paper. View the full version of the paper

Pogorzelska M, Stone PW, Furuya EY, Perencevich EN, Goldmann D, Dick A. (2011). Impact of the Ventilator Bundle on Ventilator Associated Pneumonia in Intensive Care Units. Int J Qual Health Care, 2011;23(5):538-544. View the full version of the paper. View the full version of the paper

Furuya EY, Dick A, Perencevich EN, Pogorzelska M, Goldmann D, Stone PW. (2011). Central Line Bundle Implementation in US Intensive Care Units and Impact on Bloodstream Infections. PLoS One, 6(1): e15452. View the full version of the paper. View the full version of the paper

Grota PG, Stone PW, Jordan S, Pogorzelska M, Larson EL. (2010). Electronic Surveillance Systems in Infection Prevention: Organizational Support, Program Characteristics, and User Satisfaction. Am J Infect Control, 38(7): 509-14.

Pogorzelska M, Stone PW, Cohn EG, Larson EL. Changes in the institutional review board submission process for multicenter research over 6 years. Nurs Outlook; 2010 58:181-187. View the full version of the paper

Economic Burden of HAIs

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Changes in Medicare Reimbursement

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Stone PW, Pogorzelska M, Kunches L, Hirschhorn L. Hospital Staffing and Healthcare Associated Infections: A Systematic Review of the Literature. Clin Infect Dis. 2008;47(7):937-44.

Abstract: In the past 10 years, many researchers have examined relationships between hospital staffing and patients' risk of health care-associated infection (HAI). To gain understanding of this evidence base, a systematic review was conducted, and 42 articles were audited. The most common infection studied was bloodstream infection (n=18; 43%). The majority of researchers examined nurse staffing (n=38; 90%); of these, only 7 (18%) did not find a statistically significant association between nurse staffing variable(s) and HAI rates. Use of nonpermanent staff was associated with increased rates of HAI in 4 studies (P<.05). Three studies addressed infection control professional staffing with mixed results. Physician staffing was not found to be associated with patients' HAI risk (n=2). The methods employed and operational definitions used for both staffing and HAI varied; despite this variability, trends were apparent. Research characterizing effective staffing for infection control departments is needed.

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Stone PW, Dick A, Pogorzelska M, Horan TC, Furuya EY, Larson E. Staffing and structure of infection prevention and control programs. Am J Infect Control. E-publication ahead of print.

Abstract
Background:  The nature of infection prevention and control is changing, however, little is known about current staffing and structure of infection prevention and control programs.
Objective: To provide a snapshot of the staffing and structure of hospital-based infection prevention and control programs in the United States.
Methods: A web-based survey was sent to 441 hospitals that participate in the National Healthcare Safety Network.
Results: The response rate was 66% (n =  289); data were examined on 821 professionals.  Infection preventionist (IP) staffing was significantly negatively related to bed size, with higher staffing in smaller hospitals (p < .001).  Median staffing was 1 IP per 167 beds.  Forty-seven percent of IPs were certified and 24 percent had less than 2 years of experience. Most directors or hospital epidemiologists were reported to have authority to close beds for outbreaks always or most of the time (n = 225, 78%).  Only 32% (n = 92) reported using an electronic surveillance system to track infections.
Conclusions: This study is the first to provide a comprehensive description of current infection prevention and control staffing, organization and support in a select group of hospitals across the nation.  Further research is needed to identify effective staffing levels for various hospital types as well as examine how the IP role is changing over time. 

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Stone PW, Kunches L, Hirschhorn L. Cost of hospital-associated infections in Massachusetts. Am J Infect Control. E-publication ahead of print.

The Massachusetts Department of Public Health appointed an Expert Panel to assess the problem of health care–associated infections (HAI) in the state and make recommendations regarding mandatory reporting. At the Expert Panel's request, a cost-of-illness study was conducted using available data sources. In Massachusetts, the excess hospital costs attributed to HAIs were estimated at approximately $233 to $275 million in 2006.

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