I think society has recognized that truly , infection prevention is truly everyone ’ s business ; we have been saying that for years and it has become a mantra , but I think everyone is finally embracing it now .”
— Ann Marie Pettis , RN , BSN , CIC ,
FAPIC ranks , and not just for IPs but for nursing in general , healthcare in general ,” Pettis says . “ APIC has been thinking about that as well , for we know our IPs are an aging workforce , as are nurses , and so for years we have been trying to diversify .
A lack of preparedness speaks to workforce issues , Pettis says , acknowledging that , “ I think we are all struggling with this because we don ’ t want to get caught being unprepared like we were with this pandemic . I think one of the most important things that APIC has put on the fast track – we were talking about it pre-pandemic , but now it has been escalated — and that is developing the pipeline for infection preventionists ,” she says . “ We cannot rely on people sort of stumbling onto this as a career , so we are teaming up with colleges and universities all over the country to develop a roadmap for what that will look like curriculum-wise . Work is going on fast and furious on this endeavor even as we speak because not only in healthcare do we need more IPs , but now we are in places we never before dreamt of being , such as in the food industry , the entertainment industry , we are in the school systems , we are everywhere , and we have to build a bigger boat . One of the most important things we can do as a profession is to build that pipeline .”
Pettis continues , “ We are going to need to build that bigger boat because coming out of this , people will be joining our ranks . I think society has recognized that truly , infection prevention is truly everyone ’ s business ; we have been saying that for years and it has become a mantra , but I think everyone is finally embracing it now . There ’ s an upside and a downside to that — we have said it was everyone ’ s responsibility , but we couldn ’ t seem to get there ; but now , people do definitely think it ’ s their business , which is great , but on the other hand , many think they are an expert now . One of my fears comes , as an IP , is that — because of the moving goalposts , and the fact that federal agencies were sometimes at odds with state and community leadership and public health departments — who that falls on and who gets the blowback are the IPs and the healthcare epidemiologists . We are the ones messaging around COVID-19 , and so when the goalposts are constantly moved , you start to lose the trust of people . So , I think coming out of this , it ’ s going to be critical to rebuild that trust and take back our role as the real experts in infection prevention .”
Pettis continues , “ The good news is that many of us have been invited to the table , if you will , by the C-suite , and even at the state and federal levels . For a long time , IPs have wanted to and made efforts to be at the table , to be able to influence and make a difference for HAI prevention . Finally , many of us have gotten those seats , and hopefully we will retain our places at the table when this pandemic is over . How do you address the expertise gained during the pandemic that makes many administrators and staff think , ‘ I ’ ve got this ,’ when they don ’ t have an understanding of the fine nuances and scientific literature , so I think it is a balancing act and we will have to walk that tightrope as we come out of the pandemic . I think there is more good news than bad news ,
and we can navigate and overcome many of these challenges .”
It is critical for the profession to continue to capitalize on the attention that COVID-19 has placed on IP & C , and the newfound understanding by the public , by the C-suite , by other stakeholders , and by political decision-makers .
“ As we consider the lessons learned from COVID-19 — the failures and successes , and the actions to move forward — now is the time to integrate standardized infection prevention and control education , implementation models , and evaluation metrics ,” Boston-Leary emphasizes . “ As budgets are reviewed and adjusted for the coming year , now is the time to incorporate IP & C as a budgetary line item in the form of designated funding for an infection preventionist . Now is the time to also re-evaluate communication strategies with state and local public health systems to incorporate the role of who hold a vital role in infection control preparedness and planning perspective . IP & C requires all hands on deck and it takes a village from C-suites to legislative sessions to local communities . Public safety will continue to be impacted by biological threats and IP & C investments . Considerable efforts are required to prevent a future flat-footed reactive response that could cost more lives .”
While the world ’ s attention is focused on infection prevention right now , it ’ s time for healthcare facilities to get their IP & C houses in order . The medical literature points to two significant challenges among convincing healthcare personnel to follow infection prevention and control guidelines ; the first is the discrepancy between healthcare workers ’ behavioral intentions and their implementation in practice . The other refers to how healthcare workers maintain these practices after the intervention stage ends . More institutions are looking to a concept of positive deviance ( PD ), a behavioral and social change approach premised on the observation that in any context , certain individuals confronting similar challenges , constraints and resource deprivations to their peers , will nonetheless employ uncommon but successful behaviors or strategies which enable them to find better solutions . Through the study of these individuals – positive deviants – the PD approach suggests that innovative solutions to such challenges may be identified and refined from their outlying behavior . For example , Gesser-Edelsburg , et al . ( 2021 ) used the PD approach to offer a method for disseminating practices to healthcare personnel to help them maintain IP & C guidelines , offer feedback on the dissemination process and examine the impact of the dissemination stage on changes in their behavior . As the researchers observe , “ Implementing the PD approach has the potential to reduce the gap between intentions and actual behavior reported in the literature , increase the rates of healthcare personnel compliance with infection prevention rules , and reduce infection and mortality rates .”
Key education and training gaps were exposed by the pandemic , experts say , further complicating compliance .
“ We learned through four listening sessions with nurses , spanning acute , ambulatory , community , and school health settings , that a key gap in infection prevention and control is lack of standardization of education and practice ,” Boston-Leary says . “ To that end , IP & C education is an ongoing process driven by both education and evaluation . Implementation of the principles and practices of IP & C takes a collaborative approach . IP & C does not fall on a single staff member or staffing group within a health system . Through education , staff must first understand the value of the principles and practices of IP & C and their