Facility stats
When it comes to salaries and hospital size, bigger is better. Not surprisingly, those working in hospitals with more beds, make more money. Our 2006 survey results topped out at $72,500 for facilities with 750 or more beds, while those working in a facility with up to 99 beds, earned a more modest $54,327.

The size of the facility, however, does not determine the number of infection control employees. More than 97 percent of respondents said their facility had between one and five employees, and this had no correlation to the number of beds in the hospital. ICPs who worked in hospitals with anywhere from 0-1000 beds all reported that their facility had just 1 to 5 employees. One ICP at a 200-299 bed hospital said her department had more than 30 employees, but that was the one exception. Less than 3 percent of respondents said their facility had six or more employees, even at facilities with 750-999 beds.

This year, ICPs working in suburban facilities (31 percent of respondents) were the highest paid at $66,000. While the largest percentage of our respondents (42 percent) work for rural facilities, they were the lowest earners at $53,255.

We also found that government-owned facilities paid their ICPs considerably more than their nonprofit or for profit counterparts. Salaries for those at government-owned facilities reached $69,400; non-profit facilities paid $60,233 (66 percent of respondents) and for profit facilities, $57,500.

As in previous years, about 70 percent of our survey respondents work for a stand-alone hospital, and their salaries were about 6 percent higher than last year at $58,965. Another 23 percent work for an Integrated Delivery Network (IDN) or Multi-Group practice, and these respondents earned on average $63,450. The 7 percent of our respondents who worked for a long-term care or home health facility earned an average salary of $66,470.

Regionally speaking, one-third of our respondents are located in the Central U.S., while another third reside in the Northeast region. Once again, those working in the Central region were the lowest paid at $55,259. Highest earners continue to work in the Pacific region at an average salary of $67,955. This year, the Northeast region experienced the highest salary jump, from $57,500 in 2005 to $65,675 in 2006.

More than a third of our salary survey respondents said they reported directly to either the Director/Manager of Nursing and/or the Chief Nursing Officer at their facility, while another third report to the Director of Quality/ Risk Management. New to our survey this year is the category of Chief Medical Officer, which was selected by 6 percent of respondents.

Education, education, education
"Education is the key component of infection control," emphasized Spaulding. And our survey results confirm that, indeed, education is indispensable for the ICP.

Nearly a quarter of our 2006 IC Salary Survey respondents hold a post-graduate degree, and they earn on average $68,056. Forty-five percent of respondents hold a bachelor’s degree and they earned on average $59,935.

Certification is also vital to the ICP position: Of the 65 percent of our respondents who reported that they were certified, the most common certification was from the Certification Board of Infection Control and Epidemiology (CBIC).

When it comes to licenses, nearly 80 percent of our respondents are certified as a Registered Nurse and 9 percent as a medical technologist.

Responsibilities
The average amount of work time our ICPs spent on infection control was 75 percent, though 37 percent of our respondents said they spend 100 percent of their time on infection control issues. Other duties performed by ICPs include: employee health (45 percent), education (24 percent), patient safety (15 percent), quality performance management (15 percent), utilization management (8 percent), and risk management (7 percent). Thirty percent of respondents reported "other" duties which included everything from coordinating bariatric programs, to bioterrorism response, discharge planning, environment of care safety, nursing administration, workers compensation, and wound care.

Certainly, the ICP wears many hats that may or may not relate directly to infection control, and no doubt it’s a lot for a single ICP to handle alone.

"If you think of how much teaching that an ICP [must do] at a hospital that’s 300 beds and she’s the only ICP collecting data on all of the patients that are admitted, all of the surgery cases that are done, all of the community acquired infections, how much time is left over for education? The resources have never really been there for the department to be super strong" said Spaulding.

When asked what they would like to see more coverage of in HPN, top answers from our responding ICPs included: nosocomial infections/prevention (78 percent); mandatory reporting of infections (67 percent); prevention of surgical site infections (58%); and bioterrorism preparedness (49 percent).

While only 38 percent of respondents said that their facility has stockpiled supplies to prepare for a possible flu pandemic, it’s definitely a topic of discussion among ICPs.

"ICPs are spearheading committees in some of the hospitals; they’re getting the talk going," said Spaulding of the ICP’s involvement in flu pandemic preparedness.

"There are a lot of policies and procedures going into place, a lot of talk, a lot of staff education going on," Spaulding continued. "A lot of the health departments are trying to pull together hospitals and have meetings to discuss, ‘what would we do if a pandemic happened?’ In the hospitals, some are able to set up plans, and some aren’t. Some people take it serious. They know that this could be the worst thing that our generation has ever faced should it actually turn into a pandemic. And then you have the other side of the coin, where they say, ‘it’s never going to happen, we’re not going to pay attention to it.’ So you have both of those groups in the same hospital. How do you convince them, even though it might not happen we should still have an idea of what we would do if it did happen?"

"When everybody is going to take it real serious is when the birds that are on their way to Alaska that they think may be infected with the avian influenza – when they land there and the news media says the United States now has avian influenza, you’ll see people take that concern up a level. You’ll see very rapid response by hospitals to take it more serious and prepare much quicker. So I think what ICPs are doing now, they’re starting the conversations, they’re making people aware that it’s there. And I think they’ll get a lot of help when the news media says the birds have landed."

Spaulding challenges ICPs to take the initiative to bring preparedness plans to fruition, and to encourage their hospital to participate in tracking programs set up by their state’s department of health.

"Many state departments of health are putting together programs so that when patients come into the emergency room with infections, it’s automatically put into a database, and sent off to the department of health. The department of health keeps track of the emergency room, as far as what they’re starting to see. So if we’re going to have an outbreak of something in a community, we have a better tracking system, we pick it up quicker.

"One of the hospitals that I was at recently opted not to buy into that program," said Spaulding. "They don’t want to do it, because it will take up too much of the staff’s time. Well, if you’re the first hospital to see the avian influenza, and a lot of your people get sick and possibly die, then you have no room to complain because you’re the one that opted not to do it. It should be the hospital that says, ‘yes, we’re going to do it.’"

Just the reverse of pandemic preparedness, 65 percent of our respondents said their facility is preparing procedures for mandatory reporting of infections.

"I think every hospital needs to take it serious," said Spaulding of the need to prepare for mandatory reporting of infections whether the ICP’s state has already instated laws to do so. "They need to look at what they’re doing for infection control. They need to make sure that they have good criteria for determining infections. Because ultimately, I don’t think we’re going to stop this from happening."

"And hospitals need to start preparing now," continued Spaulding. "But I don’t see a lot of emphasis on hospital management going to infection control and saying ‘OK, what criteria are we using? Are we tightening things up? Do we know that the rates we’re reporting are 100 percent accurate? Do we know what we’re comparing it against?’ They’re more or less saying, ‘infection control’s going to take care of it.’

"When the law gets passed, that’s when it will be important to them. The first time that the rates are published, they’re going to go back to the ICP, and say ‘you have to get our rates down, why are rates high?’ That’s kind of late in the game. But a lot of things that you look at from an infection control standpoint are reactive versus proactive. A lot of ICPs try to be proactive, but we can’t show that we’re saving a lot of money, always, just because of the nature of the job. Yet if we don’t do the education, if we don’t have the resources, we can’t train the staff to decrease the infections."

A bit of good news for ICPs, 10 percent more respondents than last year reported a salary increase over their previous year’s base salary, for a total of 75 percent receiving an increase that averages 3.8 percent of their base pay. Likewise, 75 percent of respondents expected to receive a bonus as part of their 2006 compensation. Also on an upward trend, 57 percent of our ICPs said they felt very secure in their current position, up from 51 percent last year.