Background: The COVID-19 pandemic highlighted gaps in infection prevention and control (IPC) practices and workforce support. This study assessed Infection Preventionists' (IPs) training needs, challenges, and resources to inform strategies supporting the IPC workforce through initiatives like CDC Project Firstline.
Methods: An anonymous survey was distributed June-August 2023 through national and state professional networks and public health programs. Participants included 267 IPs across 31 states and all 10 U.S. HHS regions.
Results: Respondents were experienced (>10 years: 70%; ≤3 years: 30%); 48% were the only IP in their facility. Leadership support varied by facility size (critical access: 75% strong engagement vs large facilities: 45%). Welch's ANOVA with Games-Howell post-hoc tests showed higher support perceptions in smaller hospitals than mid-sized facilities. Onboarding was structured for 46%, yet only 14% rated it highly effective; mid-sized facilities reported lower onboarding adequacy than smaller hospitals. Continuing education was difficult to access for 62% of IPs, and 59% reported a lack of protected time for training; no significant facility size differences were found.
Conclusions: Three key findings emerged: inconsistent leadership engagement/collaboration, inadequate onboarding/mentorship, and limited continuing education/professional development. Targeted workforce supports and system-level engagement are needed to strengthen IPC programs and sustainability.
Keywords: CDC Project Firstline; Health care capacity building; Leadership engagement; Training and mentorship; Workforce development.
Copyright © 2026 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.