infection prevention
Societies Call for Significant Need to Increase Capacity Across the U . S . Healthcare System
the world enters the third year of the COVID-19
As pandemic , the Association for Professionals in Infection Control and Epidemiology ( APIC ) is issuing an urgent call-toaction to shore up the nation ’ s infection prevention and control ( IP & C ) infrastructure .
Even before the pandemic , hospital IPC programs were underfunded and understaffed . The pandemic exacerbated those patient safety weaknesses , leaving healthcare facilities with insufficient capacity to prevent common , often deadly , healthcare-associated infections .
Published today , APIC ’ s Between a Rock and a Hard Place : Recommendations for Balancing Patient Safety and Pandemic Response , provides an extensive set of strategies to increase the IP & C workforce , strengthen prevention programs , and build resiliency for future pandemics .
“ APIC is issuing this call-to-action as we all recall the nightmare of extensive supply shortages and overworked healthcare workers ,” says 2022 APIC president Linda Dickey , RN , MPH , CIC , FAPIC . “ Especially troubling to APIC is how many preventable infections were transmitted inside hospitals during COVID because that resilience was not built into our healthcare system .”
In the report , APIC urges policymakers to allocate funding to build IPC surge capacity to ensure the continuity of safe patient care during a pandemic . The specific recommendations from the 66-page report include :
● Develop next-generation universal personal protection equipment ( PPE ) for a one-size-fits-all device to protect healthcare workers
● Normalize the use of masks by the public during outbreaks of infectious diseases , building trust among the American people of their effectiveness
● Address supply chain failures to ensure greater diversity in production locations and expanded ease of access
● Require that healthcare facilities include personnel with IP & C expertise on emergency response teams to ensure the safety of response practices
● Protect nursing home residents ensuring that each nursing home has at least one dedicated infection prevention expert on staff
● Build and implement IP & C surge capacity to ensure the continuity of safe patient care during a pandemic
● Increase capacity for testing and contact tracing to control disease spread during a pandemic
● Ensure rapid healthcare data collection and sharing to optimize strategies to prevent disease transmission
● Build vaccine confidence to combat misinformation and dissuade hesitancy
● Fund pandemic preparedness workforce capacity and training with incentives for universities to create a pathway to the infection prevention profession
In 2021 the Centers for Disease Control and Prevention ( CDC ) documented a sharp rise in healthcare-associated infections ( HAIs ), which had been steadily decreasing prior to the pandemic .
Because of the strain that the pandemic put on the entire healthcare system , central line-associated bloodstream infections ( CLABSI ), catheter-associated urinary tract infections ( CAUTI ), ventilator-associated events ( VAE ), and methicillin-resistant Staphylococcus aureus ( MRSA ) have increased exponentially .
After years of steady reductions in healthcare-associated infections , significantly higher rates of four out of six routinely tracked infections were observed in U . S . hospitals , according to a CDC analysis of data from the National Healthcare Safety Network ( NHSN ) published in Infection Control & Hospital Epidemiology . Increases were attributed to factors related to the COVID-19 pandemic , including more and sicker patients requiring more frequent and longer use of catheters and ventilators as well as staffing and supply challenges .
“ COVID-19 created a perfect storm for antibiotic resistance and healthcare-associated infections in healthcare settings . Prior to the pandemic , public health — in partnership with hospitals — successfully drove down these infections for several years across U . S . hospitals ,” said Arjun Srinivasan , MD , CDC ’ s associate director of Healthcare Associated Infection Prevention Programs . “ Strengthening infection prevention and control capacities works . This information emphasizes the importance of building stronger , deeper and broader infection control resources throughout healthcare that will not only improve our ability to protect patients in future pandemics but will also improve patient care every day .”
For this analysis , researchers used data collected through NHSN , the nation ’ s largest healthcare-associated infection surveillance system , which is used by nearly all U . S . hospitals to fulfill local , state , or federal infection reporting requirements . Major increases were found in 2020 compared to 2019 in four serious infection types : central line-associated bloodstream infections , catheter-associated urinary tract infections , ventilator-associated events , and antibiotic resistant staph infections . The largest increases were bloodstream infections associated with central line catheters that are inserted into large blood vessels to provide medication and other fluids over long periods . Rates of central line infections were 46 percent to 47 percent higher in the third and fourth quarters of 2020 compared to 2019 .
With dramatic increases in the frequency and duration of ventilator use , rates of ventilator-associated infections increase by 45 percent in the fourth quarter of 2020 compared to 2019 . The CDC analysis found sharp increases in standardized infection rates , indicating that the increases were not simply a reflection of more devices being used .
“ Infection control practices in COVID-19 wards often adapted to shortages of personal protective equipment , responded to fear of healthcare personnel , and did not always lend themselves