Invisible, Indispensable: The Vital Role of AHRQ in Infection Prevention

APIC 2025 President Carol McLay, DrPH, MPH, RN, CIC FAPIC

(Image credit: APIC)

Infection prevention is the bedrock of patient safety. Every catheter removed early, every surgical wound carefully cleaned, and every clear communication between nurse and doctor can mean the difference between recovery and harm. Behind much of this quiet, lifesaving work is the Agency for Healthcare Research and Quality (AHRQ)—a small but mighty federal agency now facing a potentially crippling 85 to 90% staffing cut.

Carol McLay, DrPH, MPH, RN, CIC, FAPIC, the 2025 President of the Association for Professionals in Infection Control and Epidemiology (APIC), expressed deep concern about losing the agency, calling it “devastating” while speaking with Infection Control Today^® (ICT^®).

While AHRQ may be a modest agency—employing just 300 staff with a $370 million budget—its impact is immeasurable. It serves as a crucial bridge between research and the bedside, turning academic insights into practical, usable tools that protect patients in real time. And no other agency performs this translational work quite like AHRQ.

McLay expressed her dismay at losing AHRQ and its work. “This is such a small department. Why are they doing this? Because absolutely, there are no inefficiencies here. None.”

McLay emphasizes that infection preventionists (IPs) are already stretched to the limit. Amid widespread staffing shortages and health care layoffs, IPs don’t have the bandwidth to convert cutting-edge research into daily protocols. AHRQ fills this void, offering actionable guidance, training toolkits, and direct support. Its absence would leave a dangerous gap—where knowledge exists but can’t be implemented.

“What's going to happen eventually is that research is not going to be utilized,” McLay said.“You have this group of people who are coming out with these wonderful initiatives to reduce health care-associated infections [HAIs], but it's not going to make it to the bedside because there's nobody to bridge that gap right between reading the research and then figuring out how to actually implement it practically. That's going to be a huge loss.”

The agency’s effectiveness is not theoretical; it is proven. Hospitals nationwide have reduced catheter-associated urinary tract infections (CAUTIs) by 30% through AHRQ-led workshops. Tools like SBAR (Situation, Background, Assessment, Recommendation) have standardized critical care communication, reducing medication errors and improving care transitions. AHRQ’s support for closed-loop communication and check-backs further minimizes human error in high-stakes environments.

McLay read several testimonials that APIC had gathered to ICT. All of them demonstrated how important AHRQ's work is.

One testimonial was on one especially impactful AHRQ initiative, its guidance on chlorhexidine (CHG) bathing protocols. While research had already shown CHG’s effectiveness in reducing surgical site and bloodstream infections, hospitals struggled to implement it. AHRQ responded by providing comprehensive toolkits, checklists, infographics, and training modules—making evidence-based practice accessible and actionable at every level of care.

“A nurse-driven catheter, Foley catheter, or urinary catheter removal protocol from AHRQ was adopted by our facilities and has reduced device usage significantly,” McLay quoted.

The testimonial gives some statistics on what they found, such as chlorhexidine. McLay said they have updated all their policies. “‘We've updated our competencies, and these tools and literature were used as house-wide reeducation for central line-associated bloodstream infections,’" McLay read. "And that's just one example of how they translate information."

The results speak volumes. McLay told ICT that 2 decades ago, the US saw nearly 99,000 deaths annually from HAIs. Today, that number has fallen to around 72,000. While still far too high, this decrease represents over 600,000 lives saved—mothers, fathers, children, and grandparents spared from preventable harm.

Beyond lives, AHRQ saves money. McLay described one health system that reported $28 billion in savings over 5 years due to reduced adverse events. The Comprehensive Unit-based Safety Program (CUSP), another AHRQ initiative, contributed to a 41% decrease in central line-associated bloodstream infections across intensive care units.

McLay makes the case that eliminating AHRQ would not only roll back decades of progress, but also place the burden of translation and implementation on under-resourced hospitals. Without AHRQ, valuable research would stagnate—never reaching the bedside, never saving lives.

McLay expressed her dismay at losing AHRQ and its work. “This is such a small department. Why are they doing this? Because absolutely, there are no inefficiencies here. None.”

ICT asked McLay how APIC could make up the slack if AHRQ is eliminated. She explained that, while APIC is exploring stopgap solutions, such as forming research networks with universities and launching its own research center, these efforts require time, funding, and infrastructure. AHRQ already has all 3. Starting from scratch would be inefficient and wasteful at best—deadly at worst.

“It also diverts resources away from other things which [APIC] could be doing,” McLay said.

In the face of growing challenges, IPs need more support, not less. Eliminating AHRQ would not only undercut the infection prevention community but also imperil patients nationwide. McLay warns that this is not about bureaucracy—it is about people. The grandmother who recovers safely from hip surgery. The child who avoids a bloodstream infection. The parent who comes home instead of being readmitted.

AHRQ may be invisible to most Americans, but its work touches every hospital room, every operating table, and every family. McLay said, “They don't understand the impact of these cuts on themselves.”