Infection Prevention and Control 2020 Review & 2021 Forecast
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Healthcare Hygiene magazine invited key thought leaders to share their perspectives for our review of 2020 and a look forward to what they believe will be continued imperatives for 2021 .
Our experts are :
Kendra McMillan , MPH , RN , senior policy advisor for nursing practice and work environment , American Nurses Association ( ANA )
Ann Marie Pettis , RN , BSN , CIC , FAPIC , 2021 president , Association for Professionals in Infection Control and Epidemiology ( APIC )
Linda Groah , MSN , RN , CNOR , NEA-BC , FAAN , CEO / executive director of the Association of periOperative Registered Nurses ( AORN )
Damien Berg , BA , BS , CRCST , AAMIF , IAHCSMM past-president , regional manager of sterile processing for University of Colorado Health
Patty Taylor , CRCST , CIS , CHL , CFER , IAHCSMM board member , clinical supervisor of central sterile for MHP Medical Center in Shelbyville , Ind ., and secretarytreasurer of the Central Indiana Chapter of IAHCSMM
Susan Klacik , BS , CRCST , CIS , CHL , ACE , FCS , IAHCSMM clinical director
Marjorie Wall , MLOS , CRCST , CIS , CHL , CSSBB , IAHCSMM board member
HHM What do you believe was the most pressing infection prevention-related issue of 2020 ( besides the COVID-19 pandemic )?
Kendra McMillan ( KM ): The first would be sepsis . Some refer to COVID-19 as a pandemic of sepsis , given the response . Second , vaccination rates are down . According to the MMWR report released on May 8 , 2020 , " Effects of the COVID-19 Pandemic on Routine Pediatric Vaccine Ordering and Administration — United States , 2020 ," there is a marked decreased in Vaccines for Children Program ( VFC ) -funded ordering and administration of vaccines . Consistent and widespread immunization is needed for preventing the spread of communicable diseases .
Ann Marie Pettis ( AMP ): Because of the pandemic , a lot of us have seen increases in HAIs . An increase in CLABSIs is one example . A working theory is that this may have been due to an effort to conserve PPE by employing extension tubing to keep IV set-ups outside of patients ' rooms . Another contributing factor may be that staff have been pulled in so many different directions with so many competing priorities . Other institutions have seen an increase in C . diff infections and CAUTIs . IPs and clinicians just didn ’ t have the bandwidth to pay attention to inappropriate testing and other prevention practices .
Linda Groah ( LG ): There was great progress in establishment of antimicrobial stewardship programs in 2019 . However , there has been an increase in multidrug-resistant organisms ( MDROs ) as an unintended consequence directly related to COVID-19 in 2020 . Issues include :
The focus on prevention and antimicrobial stewardship programs was discontinued or stopped due to COVID 19 related public health emergencies :
● Stewardship activities diminished due to pharmacists ’ focus on writing new therapeutic guidelines , overseeing clinical trials , and emergency use authorization
● Use of telemedicine saw an increase in prescribing antibiotics for respiratory and ear infections . ( This is thought to be result of inability to do physical exam or lab test , making it harder to follow prescription clinical guidelines and patients waiting to seek medical care related to fear of COVID-19 ).
● Supply shortages and disruptions in antibiotic supply
● Prolonged hospitalization and use of immunocompromising agents ( eg , dexamethasone )
● Decrease in general hospitalizations , but inpatient antibiotic usage did not change
● Less than 10 percent of COVID-19 hospitalized patients developed bacterial co-infection , but 70 percent were on antibiotics
● State and facility HAI , antibiotic use and resistance programs are understaffed and underfunded