Development and pilot evaluation of a long-stay patient infection prevention and control risk stratification tool: A single-centre service evaluation

Abstract

Background Long-stay inpatients accumulate modifiable healthcare-associated infection (HCAI) risks. Structured infection prevention and control (IPC) review processes specifically targeting these risks in long-stay inpatients are uncommon. Aim To evaluate the feasibility of a structured long-stay patient IPC review tool designed to identify and reduce modifiable HCAI risk in adult inpatients with prolonged hospitalisation. Methods This service evaluation was conducted across four adult inpatient wards in an acute NHS hospital in England between January and April 2026. Patients with a length of stay of at least 14 days underwent IPC review using an 11-item binary tool generating a total risk score (TRS; range of 0–11). Modifiable IPC risks were identified, and recommendations were communicated to ward teams, with patients re-reviewed according to risk level. Paired analysis compared initial and final follow-up TRS where repeat reviews were available. Results Fifty-two patients were reviewed across 84 review episodes, comprising 52 initial and 32 follow-up reviews. Eighteen patients contributed to the paired analysis. Mean TRS decreased from 3.33 to 2.17 between initial and final review, indicating a reduction in modifiable IPC risk. Eleven patients (61.1%) improved, while six (33.3%) were unchanged. The proportion classified as low risk increased from 61.1 to 83.3% following IPC review and intervention. Discussion This study demonstrated that a structured long-stay patient review framework could be integrated into routine IPC practice to identify and target modifiable IPC risk factors in prolonged hospital admissions. Significance and impact The findings highlight the potential role of structured long-stay review processes within preventive and predictive IPC practice.