The mental and physical health of infection preventionists has suffered during a pandemic

A high percentage of infection prevention professionals (IPs) report that stressors related to COVID-19 have worsened their mental and physical health, highlighting the need to address systemic issues that lead to burnout and improve recruitment and retention, according to survey results , reported yesterday in American Journal of Infection Control.

In a first-of-its-kind study, researchers from The Ohio State University and the Association for Professionals in Infection Control and Epidemiology (APIC) sent an email survey to a random sample of 6,000 APIC members about mental and physical well-being issues, behaviors in lifestyle and perceived support for workplace wellness during COVID-19.

Participants also answered questions from three questionnaires: Patient Health Questionnaire-2, Generalized Anxiety Disorder-2, and Occupational Quality of Life.

Most respondents (93.5%) were female aged 35 to 64 (77.1%), white (86.8%), married or in a relationship (82.5%), had a bachelor’s degree (41.2% ) or master’s (42.3%) degree, worked 9- to 10-hour shifts (58.2%), worked in hospitals (68.1%), were non-smokers (92.1%) and were light drinkers (69.3%).

Amid the pandemic, IPs have had to adapt to rapidly evolving infection prevention recommendations, personal protective equipment shortages, increased hospital-acquired infections, and greater workloads, the authors note.

Only 17% reported a high quality of life

Of the 6,000 invited, 926 (15%) completed the survey. About two-thirds indicated that they were in good physical (68.9%) and mental health (66.0%). But respondents reported low rates of getting at least 7 hours of sleep a night (34.1%), being physically active for at least 150 minutes a week (18.8%), and eating five or more servings of fruits and vegetables a day (7.3 % ), along with high rates of depression (21.5%), anxiety (29.8%) and burnout (65%).

Only 16.9% of respondents said they had a high quality of life (QOL), while 74.0% said the pandemic had worsened their mental health and 60% reported poorer physical health. A total of 37.4% reported increased alcohol consumption during the pandemic, along with poorer sleep (77%), less physical activity (64.5%), and less fruit and vegetable intake (61, 1%).

First and practicing IPs, administrators, and directors were most negatively affected by the pandemic in terms of physical health, while those in other positions were more likely to report meeting physical activity recommendations (odds ratio [OR], 2.68). Greater percentages of frontline and IP practitioners (74.1%) and administrators and directors (76.3%) also reported poorer mental health than those in other positions (61.4%).

Those with higher perceived organizational support for wellness were more likely to get at least 7 hours of sleep per night, meet recommended physical activity goals, and not smoke. Compared to IPs who say they have little or no organizational support, those whose employers support wellness “a lot or moderately” are 67% more likely to get 7 hours of sleep a night, 35% less likely to report poorer sleep and 43% less likely to report reduced physical activity.

PAs with some workplace support had higher odds of good mental health (OR, 1.81) and no depression (OR, 1.51), anxiety (OR, 1.86), or burnout (OR, 1, 77) of those with no or little support. PEs whose employers are very or moderately supportive of well-being have significantly higher odds on all indicators of good health than those with no to little support, with odds ratios ranging from 1.94 for physical health to 9.00 for high occupational quality of life.

Individuals working 9 to 11 hours or more per day were more likely to get insufficient sleep and report poorer physical and mental health than those working 8 hours or less. Greater percentages of nonwhite IP individuals were less likely to report poor physical health (OR, 0.59) and more likely to say they were in good mental health (OR, 1.58), no depression or anxiety, low stress levels and high professional QOL.

IP dialing, retention key to quality care

With a 25% vacancy rate for IPs and an estimated 40% expected to retire in the next decade, recruiting and retaining highly qualified IPs is a priority to maintain the quality and safety of health care, the researchers said.

“Given that poor physician well-being increases turnover, APIC must continue to support the importance of investing in workplace wellness cultures that promote well-being through ’empowerment, risk-taking, commitment, resilience, transparency and respect,'” they write.

The authors say healthcare organizations must act now to better protect the health and safety of IPs, including addressing systemic issues such as short staffing and long shifts that lead to burnout and ill health, and introducing or improving of mental health and screening programs.

“Infection prevention professionals have played an important role in enabling healthcare facilities to provide safe care during the COVID-19 pandemic,” APIC President Linda Dickey, RN, MPH, who was not an author of the study, said in APIC news release. “The fact that so many people are showing symptoms of burnout is troubling and should prompt employers to adopt wellness promotion programs to retain these highly skilled professionals.”

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