Exploring infection prevention: policy implications from a qualitative study.

Health care-associated infections (HAIs) are common and costly patient safety problems that are largely preventable. As a result, numerous policy changes have recently taken place including mandatory reporting and lack of reimbursement for HAIs. A qualitative approach was used to obtain dense description and gain insights about the current practice of infection prevention in California. Twenty-three in-depth, semistructured interviews were conducted at six acute care hospitals. Content analysis revealed 4 major interconnected themes: (a) impacts of mandatory reporting; (b) impacts of technology on HAI surveillance; (c) infection preventionists' role expansion; and (d) impacts of organizational climate. Personnel reported that interdisciplinary collaboration was a major facilitator for implementing effective infection prevention, and organizational climate promoting a shared accountability is urgently needed. Mandatory reporting requirements are having both intended and unintended consequences on HAI prevention. More research is needed to measure the long-term effects of these important changes in policy.