Quantifying the Pressures: Study Reveals Infection Preventionists’ Expanding Workloads

Quantifying the Pressures: Study Reveals Infection Preventionists’ Expanding Workloads

Infection preventionists (IPs) have long been the backbone of patient safety; however, the COVID-19 pandemic has pushed their responsibilities to new limits. A recent study published in the American Journal of Infection Control reveals how IPs continue to face escalating workloads, stretched resources, and shifting expectations across acute care facilities. The findings highlight not only the resilience of these professionals but also the urgent need for systemic support to sustain infection prevention programs nationwide.

Infection preventionists emerged from the COVID-19 crisis carrying heavier workloads, broader responsibilities, and fewer resources. A new study reveals the toll and the urgent need for support.

The COVID-19 pandemic illuminated the essential role of infection preventionists (IPs), but it also pushed them into uncharted and unsustainable territory. A recent study published in the American Journal of Infection Control titled “Quantifying the Progressing Landscape of Infection Preventionists: A Survey-Based Analysis of Workload and Resource Needs” sheds light on just how far the role has stretched and why organizations must rethink their approach to supporting these professionals.

In a recent discussion with Infection Control Today^® (ICT^®), study authors 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, shared their insights on how the project evolved and what the findings mean for the future.

Evolving From Crisis to Chronic Strain

According to Swain, the project began in 2023 with reflections on the workload of infection preventionists during the height of the pandemic. “Infection preventionists were asked to take on more and more, and our hands were really touching so many different departments throughout the hospital,” she explained. As the pandemic subsided, the team realized the added responsibilities had not gone away. Instead, IPs were expected to maintain expanded roles with fewer resources.

Duran emphasized that the issue was not new but had been building over time. “Coming out of [COVID-19], we were all just kind of recognizing we were in a space where we had been working so many hours—not just for a couple of months, not just for a year or 2, but this situation started even before [COVID-19],” she said. “Here we are trying to come out of it somehow or another, working more hours than we did when this all began.”

For many IP leaders, a 50- to 60-hour workweek became the norm, and postpandemic financial constraints only compounded the strain.

A Patchwork of Programs

One of the most striking findings from the team’s survey analysis was the variability of infection prevention programs. Knighton pointed out that “it was not a one-size-fits-all model,” noting her own observations and conversations across facilities. “If you have been introduced to 1 infection prevention program, you've only seen 1 infection prevention program, because no 2 are the same.”

This variability, the authors explained, underscores both the adaptability and the vulnerability of the IP workforce. Some programs are adequately resourced with supportive infrastructure, while others are left fragile, understaffed, or reliant on professionals who wear multiple hats.

Acute Care as a Focus

While the survey initially drew responses from a range of health care settings, the authors narrowed their analysis to acute care facilities to ensure validity. Doran clarified, “We didn’t have enough responses from other types of health care facilities to really articulate what was happening in their space in a way that would be value-added.” Acute care, however, provided a robust sample that helped illustrate the broader workforce challenges.

Implications for Health Care Leadership

The study highlights a critical tension: Health systems cannot achieve quality and safety goals without IPs, yet these professionals are consistently stretched beyond capacity. Layoffs, hiring freezes, and financial restructuring in the post-COVID environment have left many infection prevention programs operating with fewer staff despite higher demands.

For leaders, the message is clear. Effective infection prevention is not simply about adherence or crisis management; it is an investment in patient safety, staff well-being, and organizational resilience. By understanding the realities of IP workload and resource needs, C-suite executives and clinical leaders can make more informed decisions about staffing, program design, and cross-departmental collaboration.

Moving Forward

The authors believe their work is just the beginning of a larger conversation. By quantifying workload and resource gaps, they aim to provide IPs and health care leaders alike with data to advocate for sustainable practices.

For IPs across the country, the study validates what many already know from personal experience: the work is essential, but without adequate resources and recognition, it is unsustainable. The challenge—and opportunity—for health care organizations now is to ensure the infection prevention workforce has the tools and support needed to thrive long after the immediate crises have passed.

This is the first of a series of installments of this interview.

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