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The state of healthcare-associated infections & the pandemic

Learning objectives:

  • Review the top lessons learned for the prevention of healthcare-associated infections (HAI) during the COVID-19 pandemic
  • Review the needed comprehensive approach to pandemic readiness and healthcare team resilience
  • Discuss the future directions of infection prevention and control across the healthcare continuum of care

Presented by:

  • Dr. J. Hudson Garrett Jr.

Jump to sections:

  • Minute 7:18 - COVID-19 developments: Where we are now
  • Minute 11:00 - Healthcare personnel resilience
  • Minute 21:30 - The role of leadership
  • Minute 24:30 - Impacts on patient care
  • Minute 43:00 - Supply chain optimization
  • Minute 50:30 - Moving the needle forward

The COVID-19 pandemic has brought challenges to every healthcare sector. U.S. hospital healthcare-associated infections (HAIs) increased significantly in 2020 due to COVID-19.1 However, these challenges have also resulted in valuable lessons, particularly in infection prevention and control.

In December 2021, Dr. J. Hudson Garrett Jr., president and CEO of Community Health Associates in Atlanta, presented this McKesson Medical-Surgical webinar on the state of HAIs and the pandemic.

"We know that COVID has thrown us into a pretty massive loop," says Dr. Garrett. "But most importantly, I think it has actually brought light to how fragile our healthcare ecosystem can be in terms of staffing, personnel and leadership."

Here's a look at the lessons learned from the pandemic and how we can impact future readiness for infectious diseases, according to Dr. Garrett's webinar.

Healthcare worker resilience is a problem

It's a well-known fact that healthcare workers are experiencing exhaustion and burnout. Hospitals and long term care facilities are seriously understaffed, resulting in one of the biggest takeaways from the pandemic: the importance of protecting healthcare workers.

This goes beyond simply personal protective equipment (PPE) and into psychological PPE (a term coined by the Institute for Healthcare Improvement that means supporting and protecting your staff's mental health and well-being).2

"We are not anywhere close at a national level to reinvest in our healthcare systems," says Dr. Garrett. Some of the areas that need addressing include ensuring staff members are doing well, establishing correct staffing ratios, giving staff access to top-of-the-line equipment and knowing that leadership cares about their well-being.

According to Dr. Garrett, strategies to mitigate risk to workers include:

  • Rotating staff regularly
  • Minimizing the chances for exposure
  • Complying with PPE and other precautions
  • Tracking and monitoring illness within your healthcare community
  • Collaborating with public health authorities

Good leadership matters

Healthcare leaders have tremendous power to affect change, show the staff they support them and help build personnel resiliency.

"Like almost anything with infection prevention and control, it goes back to leadership," says Dr. Garrett. "If we've learned one thing over the last few years, it's that good leadership, especially executive leadership that is visible, tangible, supportive and motivating, is going to drive so many positive results, regardless of the care setting."

Leaders should take note of employee and patient satisfaction scores to understand the sentiment across their workforce and areas of opportunity to improve.

Healthcare-associated infection prevention practices work

Remember — and keep implementing — the core interventions for preventing HAIs as described by the Healthcare Infection Control Practices Advisory Committee.3 Examples include:

  • Hand-washing
  • Not reusing single-use needles and syringes
  • Following evidence-based PPE guidelines
  • Leadership support
  • Early removal of invasive devices
  • Training and educating healthcare personnel

"It's not good enough, especially these days, to only train individuals," adds Dr. Garrett. We also want to assess for role-specific competency," he explains. "That makes a massive difference when we look at improving overall safety."

You have the power to prevent infections: UPrevent™ can help. Created by our own clinical resource team, our UPrevent infection prevention & control program is a single source for building and enhancing your infection prevention program.

Supply chain strategies are crucial

Dr. Garrett offers several approaches to use for supply chain optimization:

1 | The ESC phenomenon

The next time you can't order the usual items, consider what Dr. Garrett calls "the ESC phenomenon." Ask these questions:

  • Efficacy: Does the product work and do what's promised?
  • Safety: Is it safe for the patient, the healthcare team and the environment?
  • Compatibility: Does the product work with equipment you already have, such as ultrasound machines, blood pressure cuffs or pulse oximeters?

If the product doesn't meet all three criteria, it's not the best solution. "We want to make sure that it's something that's going to work effectively," he says.

2 | Work proactively with supply chain vendors

No matter whom you work with, "you've got to have a plan in place and built around utilization," advises Dr. Garrett. He recommends the Centers for Disease Control and Prevention's (CDC) PPE burn rate calculator to give you a good idea of your usage.4 After you've calculated usage, you should share the figures with your supply chain vendors.

"It will give you a tremendous bang for your buck and good ROI if you have a plan in place," he says.

3 | Consider both disposable & reusable supplies

Dr. Garrett uses an elastomeric respirator, which works exceptionally well because he moves it around to different facilities.

Having both disposable and reusable supplies is also an excellent strategy for frontline healthcare personnel; that way, both types are on hand to help you through any crisis. And remember that Occupational Safety and Health Administration (OSHA) does allow you to bring your PPE to other healthcare facilities as long as it's fit-tested.

4 | Build a sustainable respiratory protection program

You should already have PPE strategies in place as part of your infection prevention and control plan. But you should also have strategies for when you anticipate a PPE shortage and when you don't have enough PPE to meet the current or anticipated demand.

"If I know that every single clinician has something they can use if we run out of our disposable products, then it makes it a lot easier to maintain clinical continuity of care," Dr. Garrett says.

Preparing for the future

This is an opportunity for the healthcare industry to evolve and prepare for the next big emergency, says Dr. Garrett. Here are some ways to prepare for 2022 and beyond.

1 | Bring everyone to the table

It takes a team approach to reduce infections and keep the healthcare team safe, including every team member, from physicians to nurses to distribution to environmental services. Involving all parties and being inclusive and communicative brings immense value, especially during difficult times.

2 | Consider building a simulation lab

Dr. Garrett is passionate about simulation labs. "It gives us the opportunity to do small change tests in a controlled environment where there's no harm to the patients or the staff," he says.

Simulation labs implement new products via a hands-on approach and give people opportunities to learn best practices by simulating the delivery of care. You can even bring in the vendor to help educate staff.

3 | Maintain honesty and transparency

"We want to make sure that healthcare data is transparent, that it's published, defendable, easily accessible and understood by a wide variety of audiences," explains Dr. Garrett.

He separates this data into three areas:

  • Things we absolutely know from evidence-based practices, such as the importance of hand hygiene
  • Things we suspect we know but are not 100% sure about, such as CDC guidance documents or expert consensus
  • Things we aren't sure about that need more research

"Not talking in terms of these [areas] is really a disservice to our teams," Dr. Garrett says. Getting other team members' ideas and input can go a long way to building trust. Transparency about the differences between these types of data can also earn patient trust.

We need to serve visibly and transparently at the frontlines, ensuring that we're ready for whatever possible challenges come next. "And this has all got to be based on data [that] will help us drive our continuous quality improvement associated with this," concludes Dr. Garrett. 


Webinar originally aired on December 15, 2021

1: https://www.cidrap.umn.edu/news-perspective/2021/09/healthcare-associated-infections-rose-2020-cdc-says
2: http://www.ihi.org/resources/Pages/Tools/psychological-PPE-promote-health-care-workforce-mental-health-and-well-being.aspx
3: https://www.cdc.gov/hicpac/recommendations/core-practices.html
4: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/burn-calculator. html 

Be advised that information contained herein is intended to serve as a useful reference for informational purposes only and is not complete clinical information. This information is intended for use only by competent healthcare professionals exercising judgment in providing care. McKesson cannot be held responsible for the continued currency of or for any errors or omissions in the information. 

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