role in implementation . This is best supported by the C-suite ’ s prioritization and investment in standardized IP & C education , IP & C models of delivery , and on-going evaluation to improve IP & C processes , protocols , and outcomes .”
Another concept that is influencing IP & C compliance is human factors engineering , the discipline that attempts to identify and address these issues , considering human strengths and limitations in the design of interactive systems that involve people , tools and technology , and work environments to ensure safety , effectiveness , and ease of use . A human-factors engineer examines a particular activity in terms of its component tasks , and then assesses the physical demands , skill demands , mental workload , team dynamics , aspects of the work environment ( e . g ., adequate lighting , limited noise , or other distractions ), and device design required to complete the task optimally . In essence , human factors engineering focuses on how systems work in actual practice , with real — and fallible — human beings at the controls , and attempts to design systems that optimize safety and minimize the risk of error in complex environments .
Regarding IPs ’ everyday objective of fighting HAIs , made even more important by the pandemic , Pettis says infection prevention and control must be hard-wired into healthcare workers ’ practices to the point it becomes automatic . This is critical , she says , pointing to recent evidence emerging from the medical literature that certain reportable HAIs are increasing .
“ There have been some casualties during the pandemic , and believe it or not , hand hygiene is one of them ,” Pettis says . “ Initially , we saw healthcare personnel doing a better job of handwashing than ever , but that waned after a while and now it ’ s worse than I have ever seen in my 40 years of doing this . That ’ s a big concern , and we ’ ve seen certain HAIs on the rise , such as Candida auris and C . difficile , and other infections caused by MDROs . We ’ ve also seen CLABSI and CAUTI rates increasing . What that tells me is because it has been such an unbelievable crisis with COVID-19 , that the laser-focus that we have all had to place on SARS-CoV-2 , is taking our attention away from other infections . We can ’ t keep all the plates spinning at the same time and they are beginning to crash down . Everyone – not just IPs – but nurses , physicians and the C-suite , are recognizing that infections are gaining on us again and so we are trying to put that genie back in the bottle . I do think healthcare personnel can get complacent about the things they are not focused on . One bright spot is that because of COVID-19 , healthcare workers are finally wearing eye protection , which I hope comes out of this pandemic as a lasting effect because prior to that , you couldn ’ t get people to wear any kind of eye protection and now they are so eager to do it .”
Pettis adds , “ All of the issues we were working on before the pandemic are going to be incredibly important as we emerge from the pandemic and hopefully do not face a fourth wave . I believe that human factors engineering within systems is going to be very important for ensuring compliance , protecting patients , and forcing us to do the right thing , such as engaging in hand hygiene . Making infection prevention and control practices habitual and automatic is where we need to continue to go , and technology and revisiting bundles of best practices may help us get there . In my facility we are going to start rounding again , to not just see if healthcare personnel are doing the right things to protect themselves and their patients from COVID-19 , but are they doing the right things in terms of caring for central and peripheral lines and urinary catheters and is antibiotic stewardship and diagnostic
7 Essential Activities for Effective Infection Control
COVID-19 is highly transmissible and has a high mortality rate . With the entire population susceptible , it ’ s critical for healthcare organizations to do everything possible to control its spread .
An effective infection control program aims to prevent infection transmission ; protect staff , patients , and visitors ; and identify , isolate , and treat infected individuals . As organizations implement and fine-tune their protocols and procedures for COVID-19 , they will be better prepared for future emergencies . 1Designate a single source of truth within the infection prevention department or medical staff . Rely on key staff to interpret , monitor , and update the latest scientific findings and most relevant guidelines and recommendations for screening and treatment . With novel viruses such as COVID-19 , practitioners are constantly learning new things about the virus ’ s behavior , transmission routes , and pathology . It is crucial to keep all staff members up to date .
2
Make changes to daily routines to promote hygiene and implement source-control measures . Screen individuals for symptoms before they enter the organization . Healthcare personnel with symptoms should be sent home and asked to follow their occupational health protocols . Patients should be placed in designated isolation areas to await further evaluation . Continue screening patients throughout their hospital stay . Apply appropriate source control measures , including physical distancing of at least six feet , to reduce transmission . Visitors and patients should wear their own face masks or be provided face masks upon entry . Healthcare personnel should use face masks as a measure of source control while in the facility . For areas with moderate to high levels of community transmission or anticipated exposure in low transmission areas , staff should use eye protection as well and take standard infection prevention and transmission precautions . Use N95 or equivalent type respirators during aerosol-generating procedures and for surgeries with a higher risk of transmission . Educate staff on the proper use of PPE , particularly on donning and doffing procedures . Think creatively about ways to protect your environment ( for example , redesigning patient placement plans and shared / congregating spaces or installing plumbed sinks and shoe-cleaning stations directly outside of entrances for use by staff , patients , and visitors ). Remember that while source-control interventions reduce transmission , they do not prevent it . Hand hygiene , the only method to prevent transmission , remains a best practice . Maintain an adequate supply of soap and antibacterial solutions . If necessary , partner with local suppliers that manufacture these supplies in non-traditional environments such as distilleries . Manage the supply of resources to meet infection
3 control needs — short-term and long-term .
Identify who in the organization may contact and expand the supply network . In a pandemic situation , facilities will use greater quantities of PPE , oxygen equipment , and isolation rooms than previously planned , and suppliers will experience service disruptions and delays . Implement PPE surveillance :
●Conduct daily counts and update usage and reuse policies and protocols .
●Measure days of supplies on hand and the days of utilization to which that translates .
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