My principal field of scholarship is grounded in infectious disease epidemiology and health services research and I have used theories and methods from these fields to focus my research on the prevention of healthcare-associated infections across the healthcare continuum. I have been involved in several research projects examining the relationship between evidence-based policies and healthcare-associated infection rates in the elderly population admitted to acute care and the cost-effectiveness of interventions aimed at reducing these costly adverse events. In addition to the work that I have done in the acute care setting, I am also currently working on projects examining infection prevention in the long term and primary care settings.
Infection Prevention and Control in Ambulatory Care Settings: A Pilot Study
The objective of this pilot study is to identify the structures and resources available for infection prevention and control in ambulatory care settings through a survey of Infection Preventionists (IPs) practicing in the Philadelphia-Delaware Valley area. Specifically, the aim is to examine the implementation of infection prevention, control and surveillance policies and practices in the ambulatory care setting and to describe the current spectrum of role and responsibilities of IPs working in this setting.
Institutional and Patient Level Predictors of Multi-Drug Resistant Healthcare-Associated Infections
As part of my dissertation research I examined patient-level and institutional-level risk factors for infections caused by multi-drug resistant organisms (MDRO). To do this, I conducted a nested case control study using two sets of controls and showed that risk factors differed greatly based on the control group chosen highlighting the need for careful selection of appropriate control groups in studies examining antibiotic resistant infections and careful adjustment for underlying severity of illness. Additionally, I investigated the relationship between hospital structural characteristics such as staffing and infection control resources, policies directed at controlling and preventing MDRO and MDRO rates using data from two hospital surveys. My research showed wide variation in MDRO control and prevention policies in place in U.S. hospitals and identified several important predictors of lower rates of methicillin-resistant Staphylococcus aureus including the presence of an infection control director certified in infection control.
Prevention of Nosocomial Infections and Cost Effectiveness Analysis Refined (PNICER Study, R01NR010107, PI: Patricia Stone, Columbia University School of Nursing).
From 2007-2014, I was part of the research group led by Dr. Stone that has investigated the relationship between evidence-based policies and healthcare-associated infection rates in the elderly population admitted to acute care. As part of this group, we conducted several surveys of infection preventionists in acute care hospitals to examine policies and resources directed at preventing infections in this setting. Additionally, we investigated the long-term outcomes of community and healthcare-associated pneumonia and bloodstream infections in the elderly and the cost-effectiveness of interventions aimed at reducing these costly adverse events.