By Vitalacy Team Member
A Centers for Disease Control and Prevention (CDC) analysis published in Infection Control and Hospital Epidemiology (Lastinger et al., 2022) showed continued increases in healthcare-associated infections (HAIs) during 2021, the second year of the COVID pandemic. With the nation’s hospitals bracing for a combination of COVID and flu cases during 2022 and 2023 due to reduced precautions such as mask wearing, the road ahead doesn’t look easier.
According to a group of infection preventionists published by Wolters Kluwer Expert Insights (Weise, Weissenbach & Jordan, 2021), improving resiliency and increasing remote electronic surveillance will be necessary to address rising infection rates at a time of staffing shortages.
1. A need to increase resiliency, strengthen emergency response
MacKenzie Weise, MPH, CIC, an infection prevention clinical program manager, recommends focusing infection prevention and control investments into ways to increase resiliency. Two ways include increasing surge capacity and increasing access to informatics tools. Better surge capacity enables infection prevention and control staff to quickly adapt to higher volumes of patients; tending to staff education and mental/physical support helps staff to stay ready. Better informatics improves surveillance and data management and analysis, leading to quicker risk identification and earlier intervention (Weise, Weissenbach & Jordan, 2021).
Devin Jopp, EdD, CEO of the Association for Professionals in Infection Control and Epidemiology (APIC), advocated for strengthening emergency response in a recent Forbes article. He recommends creating and regularly testing emergency response programs and making sure the right staff are on emergency response teams.
2. Higher infection rates
In the third quarter of 2021, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), ventilator-associated events (VAE), and laboratory-identified methicillin-resistant Staphylococcus aureus (MRSA) bacteremia standardized infection ratios (SIRs) were significantly higher compared to the SIRs from the previous 2021 quarters and the corresponding pre-pandemic quarter. The CLABSI and VAE SIRs were higher in 2021-Q3 than during any previous quarter since the beginning of 2019. The number of VAEs during 2021-Q3 was 149% higher than the number reported during 2019-Q3, and the ventilator SIR increased by 40% from 2019-Q3 to 2021-Q3 (Lastinger et al., 2022).
Matt Weissenbach, DrPH, CPH, CIC, FAPIC, a senior director of clinical affairs, observed sharp declines in Clostridioides difficile infection (CDI) and antimicrobial prescriptions during the pandemic due to a dramatic reduction of primary care consultations, during which most antibiotics are prescribed. He predicts antibiotic prescriptions and CDI infections will begin to increase as individuals begin to resume receiving primary care in typical fashion (Weise, Weissenbach & Jordan, 2021).
3. A shortage of infection preventionists, coupled with an aging population
According to Tom Jordan, RN, BS, CIC, an infection prevention clinical program manager, a rapid increase in population growth and aging coupled with the exodus of experienced infection preventionists from the workforce will pose challenges to HAI prevention. The aging population will result in individuals presenting to hospitals with co-morbidities requiring complex care, increasing the risk of HAIs (Weise, Weissenbach & Jordan, 2021).
To address the shortage of infection preventionists, hospitals have begun to implement remote, electronic infection prevention surveillance applications that identify patients at risk for developing HAIs and that detect possible HAIs early. Jordan predicts remote electronic surveillance will grow as a solution to managing an aging population with a smaller pool of infection preventionists (Weise, Weissenbach & Jordan, 2021).
Preventing infections in the first place may be the best strategy of all
Electronic monitoring of hand hygiene compliance can help to prevent HAIs in the first place. These automated solutions provide accurate measures of individual, unit and organizational hand hygiene compliance that set baselines for improved compliance. Vitalacy’s Automated Hand Hygiene Monitoring Solution can provide vibration hand wash reminders to wearables on the wrists of care providers; these wearables can also measure hand wash duration. Vitalacy's experience with St. Mary's Healthcare System for Children in Queens, New York, showed a correlation between longer hand wash duration and reduced healthcare-acquired infections (Vitalacy Case Study).
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Jopp D. 4 actions healthcare leaders can take to prepare for future outbreaks. Forbes, Oct. 5, 2022.
Lastinger L, et al. (2022). Continued increases in the incidence of healthcare-associated infection (HAI) during the second year of the coronavirus disease 2019 (COVID-19) pandemic. Infection Control & Hospital Epidemiology, 1-5. doi:10.1017/ice.2022.116
Weise M, Weissenbach M, and Jordan T. What’s ahead for infection prevention? 2022 predictions from clinical experts. Wolters Kluwer Expert Insights, Dec. 21, 2021