many short-term actions that have been implemented related to the pandemic that are not consistent with accepted infection control practices – returning to acceptable practices will be a slow process . Specific issues around PPE , medications , and equipment .
PT : Staffing is truly a huge issue . Our pay scale doesn ’ t match our risk level and that is what ’ s going to hurt us if we can ’ t offer more to those who work in healthcare facilities .
MW : Separate from COVID-19 , we will continue to see challenges with processing highly complex instruments like orthopedic and spine loaned instruments , robotic instruments , and flexible scopes . Manufacturers are working with sterile processing experts to design these instruments to be more intuitive and capable of effective consistent decontamination , inspection and sterilization ; however , until this is solved at an industry-wide systemic level , we will continue to have processing failures potentially leading to patient harm .
HHM What are the scientific research gaps that you hope will be addressed in 2021 ?
KM : Given the current reuse and decontamination practices of vital PPE , it is critical to have scientific research on the safety of these crisis measures based upon the current practice environment , versus a laboratory setting . It ’ s important to know the true safety of preservation and crisis strategies , such as extended use coupled with reuse . It is also important to have accurate data collection on the rate of COVID-19 exposure within a healthcare setting due to lack of sufficient PPE and use of crisis strategies to further inform preparedness strategies . Other key scientific gaps include racism in health care systems , and the patient ’ s experience post COVID-19 .
AMP : It will be interesting to evaluate safety of the new vaccine . There ’ s a robust national system to collect information from clinicians as well as those receiving the vaccine . Also of importance is critical review of the ongoing literature that ’ s often contradictory such as the effectiveness of the different treatment options . One example is monoclonal antibody infusion -- is the “ juice worth the squeeze ” since this treatment option is not easy to operationalize , particularly in the ambulatory setting . I personally want to see definitive proof of efficacy on the difference between face masks and N95 respirators . How effective have face shields been in preventing transmission ? Are we donning correctly or re-contaminating ourselves during doffing ? I also look forward to more research on antibody development – how long does immunity last ? How often will we need to vaccinate ? What ’ s the difference between the 1-shot and 2-shot regimen ? One challenge is that so much of the literature is coming out quickly . And then subsequent reviews contradict the literature . So , there ’ s this ongoing sifting , sorting , and vetting of the literature . In the meantime , IPs can feel like ping pong balls – going back and forth trying to understand it , get staff to follow it , etc .
LG : What are the potential impacts of a pandemic on the hospital transmission of MDRO ? What is required to provide mental health assistance to healthcare workforce during a pandemic ? The World Economic Forum ( WEF ) report in 2013 stated , “ while viruses may capture more headlines , arguably the greatest risk of hubris to human health comes in the form of antibiotic-resistant bacteria .”
DB : Asking us to do sterile processing practices ( cleaning , disinfection and sterilization ) with little to no background highlights the biggest scientific research gaps , which are the following : dealing with practice and tradition ; dealing with new technology ; and questioning whether the education and standards keep up . With the implementation of the Emergency Use Authorization by the FDA , it has opened up a very different world of challenges that we will need to address with solid research and evidence in 2021 .
PT : Hopefully , we will get a vaccine that people won ’ t be afraid to receive and that works for all of us , no matter where you work .
SK : I would say : How to perform safe external transport of sterile items without compromising their integrity of packages that were prepared at a healthcare facility or healthcare medical device processing facility .
HHM What are your words of encouragement or advice to the infection prevention / healthcare epidemiology community as we head into the new year ?
KM : Infection prevention is a team effort and your role as a health care expert is vital , but it ’ s important to call on the healthcare team to be good stewards of IP & C if we are truly going to improve the quality and safety of healthcare . Seek out your IP & C champions who can lead by action and solicit ideas at the unit level to develop real-time IP & C solutions based upon current barriers and challenges .
AMP : Both APIC and SHEA have done a good job of trying to address the needs of their members – providing education and information , resilience training , and emotional support . We ’ ve experienced colleagues in our own ranks becoming seriously ill from COVID and sadly many of us have lost loved ones due to COVID . We are all affected by the collective grief , sadness , and stress . It ’ s critically important to know where to get emotional support and to try to stay connected with your loved ones . Otherwise you can feel isolated and marginalized . Stay connected as best as you can . Listen to your body and your emotions .
LG : We will enter 2021 with lessons learned during the 2020 :
● Increased communication and support within facilities regarding infection prevention .
● Reliance on a team approach in facilities to discuss the problems each day and arriving at the best practice solution for that day for each patient .
● Awareness that the members of the team focused on infection prevention and epidemiology are vital members of the team .
PT : I believe we all want the same things : a healthy , happy and safe work environment . I also believe if we all work together , we can achieve anything .
SK : Continue following best practices . Following best practices provided to SP with a roadmap on how to respond to the COVID-19 pandemic as we processed medical devices .