By Haley Dukelow, VP Operations
Two recent articles show the detrimental impact of COVID-19 on healthcare-associated infections (HAIs) and patient safety; these reports also provide guidance on what healthcare organizations must do to renew their commitments to safety culture in the post-COVID-19 environment.
The first article, "The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: A summary of data reported to the National Healthcare Safety Network," (Weiner-Lastinger, et al., 2021) provides data showing nationwide increases in HAI incidence during the pandemic year of 2020.
Published in Infection Control & Hospital Epidemiology, the report highlights the need for healthcare organizations to return to conventional infection prevention and control (IPC) practices as COVID-19 becomes better controlled.
Weiner-Lastinger, et al., 2021, documents significant increases in national standardized infection ratios for central-line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia during 2020.
The article further notes that a widespread decrease in HAI incidence had been observed across United States hospitals during the first quarter of 2020 prior to the pandemic, and says that trend began to reverse as hospitals began to respond to COVID-19. The incidence of CLABSI jumped 27.9%, 46.4% and 47.0% over the next three 2020 quarters. CAUTI incidence didn't change in the second quarter but increased 12.7% and 18.8% during the next two quarters. VAE increased 33.7%, 29.0% and 44.8% over this same 2020 time period, and MRSA increased 12.2%, 22.5% and 33.8%.
The report also states that the increased focus on hand hygiene, environmental cleaning, patient isolation, and use of PPE during 2020 may have resulted in decreases in HAIs if not for the pandemic.
The second article, "How to bounce back after COVID-19's safety declines," (Press Ganey 2021) documents a decline in overall safety culture and nurse-sensitive outcomes, despite healthcare organizations making tremendous gains in COVID-19 safety.
The report states that "the stresses of and singular focus on COVID-19 caused routine safety issues – like medication errors, falls and CLABSIs – to worsen."
The report compares rates of falls, pressure ulcers and CLABSI during COVID-19 (March 2020 and later) vs. pre-COVID-19 (February 2020 and earlier). Gathered from the National Database of Nursing Quality (NDNQI), these rates rose across various healthcare settings during the pandemic.
The article attributes these rising rates to a dynamic it calls "drift". During the pandemic, "organizations were laser-focused on surviving – and beating – the virus," the report states. This focus led to exhaustion, unprecedented levels of burnout, and turnover and staffing gaps, making it more difficult to maintain conventional IPC measures.
The Press Ganey article offers various tactics healthcare organizations can implement to bounce back from COVID-19 and renew their commitment to safety culture. Weiner-Lastinger, et al., 2021, emphasizes the importance of "building resiliency in programs to withstand future public health emergencies."
Improving safety culture through better employee engagement
At Vitalacy, we're thinking into the future with a vision of better patient and worker safety. As part of our Patient Safety Platform, we provide hand hygiene compliance monitoring and are developing a Fall Risk Alert Solution powered by artificial intelligence.
In all of these technology solutions, Vitalacy has taken human factors into consideration, with an eye toward making work easier, not harder. Our solutions can reduce burnout and improve employee engagement – which research shows is tied to safety culture improvement (Wright & Libby, 2021; Gandhi, 2021). As part of any technology implementation, Vitalacy works closely with care providers to encourage their participation and earn their buy-in and engagement.
Gandhi T. Breaking down silos to advance caregiver and patient outcomes. Press Ganey blog, Sept. 16, 2021.
Press Ganey. How to bounce back after COVID-19's safety declines, Oct. 4, 2021.
Weiner-Lastinger LM, et al. The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: a summary of data reported to the National Healthcare Safety Network. Infection Control & Hospital Epidemiology, Sept. 3, 2021.
Wright M & Libby N. Supporting patient safety requires higher employee engagement. Press Ganey blog, Aug. 20, 2021.