Invest in Prevention Now: Funding and Vaccination Are Keys to Safer Hospitals

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Infection prevention is too often the first program cut when budgets tighten, but experts warn that underfunding leaves hospitals vulnerable. Stronger policies, bigger rewards, and robust vaccination programs are critical to protecting patients and communities.

In this next installment of this Infection Control Today® (ICT®) interview with authors of a recent study titled “Quantifying the progressing landscape of infection preventionists: A survey-based analysis of workload and resource needs,” the authors discuss funding and how vaccination can be part of the solution.

The authors are Brenna Doran, PhD, MA, who specializes in hospital epidemiology and infection prevention at the University of California, San Francisco, and is a coach and consultant in infection prevention; Jessica Swain, MBA, MLT, director of infection prevention and control at Dartmouth Health in Lebanon, New Hampshire; and Shanina Knighton, an associate professor at Case Western Reserve University School of Nursing and senior nurse scientist at MetroHealth System in Cleveland, Ohio.

Financial constraints remain one of the most significant barriers to adequate infection prevention (IP) staffing, according to infection preventionists who stress the need for stronger policy and funding support. Knighton urged, “Hospitals should work with state and national leaders to change policies that fund infection prevention programs. It’s one of the things that’s always on the chopping block first, which is unfortunate—not just for infection prevention, but for public health in general.”

Current federal reimbursement models do little to incentivize investment. “Medicare and Medicaid already reward hospitals for keeping infection rates low, but we should be pushing for bigger rewards so we can invest more into infection prevention teams,” Knighton noted. Conversely, hospitals with high infection rates lose funding—evidence, they argue, that IPs help protect both patients and a hospital’s bottom line.

But success in infection prevention is often invisible. “Our success is tied to the reduction of HAIs, but that’s maybe only 25 to 30% of what we do. When you have a strong IP program, you almost don’t know we exist,” Doran said. “How do you quantify the savings of not having an outbreak?”

Participants also called for expanded grants and emergency funding. “We just don’t have enough public health emergency funds… whether we’re talking about natural disasters, pandemics, or outbreaks like measles or [tuberculosis],” Knighton said. “We need to strengthen programs long-term instead of always playing catch-up.”

Vaccination programs were highlighted as essential tools. IPs are doing their best to ensure patients understand how vital vaccination is. “We, as infection preventionists, are really trying to make sure that we are able to confidently and articulately tell that story about how serious the implications can be if we are not doing the things that we can be doing to prevent these preventable diseases.”

Doran said, “We get vaccinated for everybody that we could potentially come in contact with, who could fall, who could become infected with these diseases because they can't get vaccinated.”

For hospitals, investing in infection prevention is not just compliance; it is a matter of saving lives and sustaining trust.

This is the fifth installment of this interview. The first can be found here. The second can be found here. The third can be found here. The fourth can be found here.

Reference

Doran B, Swain J, Knighton S. Quantifying the progressing landscape of infection preventionists: A survey-based analysis of workload and resource needs. Am J Infect Control. 2025;53(6):669-677. doi:10.1016/j.ajic.2025.03.012

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 Brenna Doran PhD, MA, hospital epidemiology and infection prevention for the University of California, San Francisco, and a coach and consultant of infection prevention; Jessica Swain, MBA, MLT, director of infection prevention and control for Dartmouth Health in Lebanon, New Hampshire; and Shanina Knighton, associate professor at Case Western Reserve University School of Nursing and senior nurse scientist at MetroHealth System in Cleveland, Ohio
 Brenna Doran PhD, MA, hospital epidemiology and infection prevention for the University of California, San Francisco, and a coach and consultant of infection prevention; Jessica Swain, MBA, MLT, director of infection prevention and control for Dartmouth Health in Lebanon, New Hampshire; and Shanina Knighton, associate professor at Case Western Reserve University School of Nursing and senior nurse scientist at MetroHealth System in Cleveland, Ohio
 Brenna Doran PhD, MA, hospital epidemiology and infection prevention for the University of California, San Francisco, and a coach and consultant of infection prevention; Jessica Swain, MBA, MLT, director of infection prevention and control for Dartmouth Health in Lebanon, New Hampshire; and Shanina Knighton, associate professor at Case Western Reserve University School of Nursing and senior nurse scientist at MetroHealth System in Cleveland, Ohio
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