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We know that pandemic resources for
IP & C were reduced and not scaled up to meet the additional burden of taking on the pandemicrelated tasks that we know were a lot of extra work . “ Public health partners were impacted post-pandemic monetarily and as well as staffing-wise .” — Tania Bubb , PHD , RN , CIC ,
FAPIC
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the science and expertise as well as vaccine hesitancy , and all these factors threaten our programs and resources .”
Talbot added , “ There are challenges through the pandemic and then especially now with ongoing impacts on resilience , not only within our own IP & C workforce but our larger healthcare worker workforce and healthcare system resiliency . IP & C programs have many competing priorities , and they are strained , much like a rubber band that was stretched pretty far but doesn ’ t have that same elasticity . There are numerous issues that impact us daily as we try to work together to improve behaviors to reduce infections . It ’ s a challenge to figure out how to prioritize ; how do you say X is more important than Y , as you can only use so much of your resources to address Z , and you can ’ t address A or B or C . Within the healthcare system , there ’ s competition to obtain resources such as budgets , staffing and IT support , and that will continue to strain IP & C programs . And so how do we advocate for the importance of our programs ? This is bad in acute-care settings , but this is even worse in non-acute-care settings like long-term care . If you think about an already strained , resource-low area , and now even further strained in terms of these kind of post-pandemic challenges , it ’ s tough . As we think about why IP & C may feel challenged in being valued , I think this goes back again to the struggle to show the benefit that we provide . We know what we do , and the day-to-day impact that we are making in reducing harm and infections . But those cost savings are hard to accurately quantify , and how do we know that it was due to our activities in IP & C ? I can ’ t show I improved hand hygiene by X and it cost-saved you Y . Now , there are some attempts to do that , but that ’ s why it ’ s hard . And so how do you kind of make that advocacy ? We talked about burnout and exhaustion among healthcare workers in general , and it really is a factor with us as well .”
Bubb pointed to the connections between the resilience of healthcare workers and healthcare systems related to the resilience of the overall public health infrastructure . “ This infrastructure was not great
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to begin with and it has gotten worse because of lack of funding . Many healthcare facilities and systems are struggling to recover from the impacts of COVID-19 , and healthcare systems are generally not prepared for the next crisis . No other group has our expertise or experience . We know that the coordination of ongoing multidisciplinary work is needed to protect patients and healthcare workers . And we know that to respond to prevent transmission of new and re-emerging infectious diseases takes a lot of coordination .”
She outlined several opportunities related to the current state of IP & C , and the importance of harnessing the impact of IPs ’ work during the pandemic . “ We must push to further address all infectious harms in all types of healthcare facilities , including long-term care and home health . We need to raise the bar on expectations for IP & C program structure , leadership , and resources in all types of healthcare facilities . And we must develop a sustainable workforce program to ensure adequate staffing to meet all IP & C needs and anticipate upcoming retirements .” Bubb cited sources indicating that up to 40 percent of the current IP workforce may be retiring in the next six to eight years , and that there is a surging demand for IPs .
A guidance document that may help IPs advocate for IP & C program resources is a SHEA / APIC / IDSA multi-society position paper , “ Raising the Bar : Necessary Resources and Structure for Effective Healthcare Facility Infection Prevention and Control Programs ,” that has been in development for the last two years , according to Talbot . “ We are closely examining the need for the advocacy for IP & C program resources ,” Talbot said . “ It is a very big document , but we think it covers essential points including that IP & C programs have a larger impact than just HAI reduction , are essential and foundational parts of all healthcare facilities , and are under-resourced and threatened by unexpected events / emergencies . This whitepaper is really for the people who fund IP & C programs at healthcare facilities , so , the leadership and the people who influence that funding , as well as our regulatory partners so they can see we play a key role
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not only in reducing HAIs but that we manage and mitigate infectious harms daily .”
Talbot continued , “ The other thing that we ’ re going to advocate in this paper is that we move the bar from programs being an active infection prevention and control program to also effective . Now that does not mean that everybody has an ineffective program , but it points out there ’ s not a lot out there that provides guidance to facilities on how you should do an IP & C program . What we ’ re going to do is push it further than the CMS condition of participation requirement that the hospital must have an active hospital-wide program for the surveillance , prevention and control of HAIs and other infectious diseases . ‘ Active ’ is a subjective word . I could be at a facility that has an infection prevention committee that ’ s very active , meets monthly , headed by a physician , we have IPs , we have our policies . We report all our HAIs to CMS and we look good on those . The Joint Commission came by and gave us no citations . That seems like a pretty active facility , right ? But what about a program that proactively partners with the frontline staff and proactively partners with frontline staff to assess IP & C practices ? It reports required HAIs but also tracks other infectious threats , per risk assessment , as well as conducts rigorous review of HAIs to assess variability in practices , develops action plans for improvement , and communicates IP & C expectations for all personnel . I would say that the second facility is active but also probably more effective than the first facility . So , how do we move the bar from active to effective ? It ’ s going to take time to move that bar , but that ’ s the goal .”
Bubb addressed this need to move toward effective IP & C programs , noting that these programs need to be adequately and appropriately resourced , led , and supported .
“ Some of you are working under very challenging circumstances , where ‘ adequately and appropriately resourced ’ may not be as easily attained ,” Bubb acknowledged . “ But I think this whitepaper will be codified , and so it will become a roadmap to justify why we need more resources .”
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