from the editor
Screening and Isolation Practices in the Pandemic
Screening of patients upon admission for multidrug-resistant organisms ( MDROs ) remains a debatable practice among infection preventionists and healthcare epidemiologists , and the dialogue sharpens throughout the COVID-19 pandemic , as asymptomatic inpatients and healthcare workers challenge an already stressed healthcare sector .
In their recent study , Stadler , et al . ( 2021 ) acknowledge that , “ Systematic screening of asymptomatic inpatients revealed a low total number of SARS-CoV-2 infections , yet a stable proportion of asymptomatic carriers over time . This result is in line with other findings .” They conclude , “ The high number needed to screen , to identify asymptomatic SARS-CoV-2 infected patients , questions the benefits of systematic on-admission screening . The substantial proportion of asymptomatic SARS-CoV-2 infections , even in a low prevalence setting , emphasizes the need for universal infection and transmission control measures in healthcare institutions to prevent onward transmission by undetected SARS-CoV-2-carriers .”
To this end , the COVID-19 Research Agenda for Healthcare Epidemiology , released recently by the Society for Healthcare Epidemiology of America ( SHEA ), endeavors to address research gaps relating to standard and transmission-based precaution practices ( among other priorities ).
As the SHEA whitepaper ( 2021 ) reminds us , “ Standard and transmission-based precaution practices are a cornerstone to prevent transmission of infectious pathogens and to ensure HCP and patient safety across all healthcare settings … Yet , as the COVID-19 pandemic continues to unfold , so does the need for a more rigorous evidence base to inform isolation practices and to assist healthcare facilities with effectively implementing public health guidance .”
The whitepaper has identified three research domains that represent priority areas with unanswered questions in isolation precautions relevant to healthcare and infection prevention :
●Determine when and how to initiate transmission-based isolation precautions for COVID-19 .
●Determine how to optimize management and care delivery while isolation precautions are in place .
●Determine when to discontinue COVID-19 isolation precautions and reinstitute isolation in cases of possible re-infection .
As the whitepaper notes , “… questions remain about the effectiveness of various screening and testing protocols to initiate isolation precautions practices and reduce transmission risk .” Additionally , the whitepaper points out , “ Research to better understand , identify , and test approaches to mitigate the psychological , physical , and care delivery challenges related to COVID-19 isolation precaution practices , including the benefits and unintended consequences of family / visitor policies and restrictions , are needed .”
In this issue , we explore healthcare professional occupational health as well as significant healthcare hazards , many of which have been fueled by the pandemic ; we hope it offers some food for thought and helps inform your safety decision-making .
Until next month , bust those bugs ! Kelly M . Pyrek Editor & Publisher kelly @ healthcarehygienemagazine . com
References : Mody L , et al . COVID-19 Research Agenda for Healthcare
Epidemiology . ICHE . 2021 .
Stadler RN , et al . Systematic screening on admission for SARS-CoV-2 to detect asymptomatic infections . Antimicro Resis Infect Control . Vol . 10 . 2021 . healthcarehygienemagazine
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