GENERAL INFECTION PREVENTION AND CONTROL
Is it the end of IPC?
In the presentation,“ The End of IPC?” Andreas Voss, professor and chair of the Medical Microbiology and Infection Control department at University of Groningen in The Netherlands, recalled what he described as the“ good old days” when infection prevention and control life was simple:“ When microorganisms kept their names for years; when resistance was just indicated by an“ R” and not hundreds of abbreviations for genes, enzymes and mechanisms; when hand hygiene and contact precautions still worked, just not used enough to prevent trouble; when administrators were still your colleagues and not managers who think of costs instead of needs and quality; when sustainability was talked about for our environment but didn’ t dominate decisions regarding IPC; when innovation and change was slow and done by ius and not an unpredictable storm driven by AI and people from outside IPC,” Voss said.
He addressed the COVID-19 impact on the profession by noting,“ COVID came along, the big scare, and suddenly people said,‘ We need you from infection prevention and control,’ so this was a good time for us, in that our profile was raised. So, now we are living in the post-COVID era, and what has it done to IPC? During the pandemic we were at the top but then we took a steep fall afterward,” he said, pointing to the conflict of opinions about the state of science and declining trust in public health authorities.
Voss also said that the necessity of breaking the rules did not help the bigger picture of IPC practice compliance, seeing as once habits are engrained, it can be nearly impossible to revert to what are recognized as evidence-based practices.
“ During the pandemic there were shortages so we had to break the rules and allow things we hadn’ t allowed previously, and now the fun part is that you try to re-implement the rules you broke or allowed others to break and now they say,‘ Why should I follow those rules?’ These clinicians forgot the reasons they had to comply, and now we have what I call the pandemic side effects – things that were outside of infection control but also happened due to the pandemic. And one of those is that the environmental impact of needed precautions was emotionalized; there was tremendous waste generated by use of so much PPE, and despite proper waste disposal in many places, this was the kickoff of a green movement within healthcare. In general, this is good, but for IPC there was a new threat – the uncontrollable green caregiver. They believe that sustainability is
COVID came along, the big scare, and suddenly people said,‘ We need you from infection prevention and control,’ so this was a good time for us, in that our profile was raised. So, now we are living in the post-COVID era, and what has it done to IPC?
their No. 1 priority, with IPC subverted to that. Even worse, IPC practices are in their way. But think about glove use; we can save more than 50 percent or closer to 75 percent if clinicians adhered to our rules instead of their idea of protecting themselves. Without attention to sustainability, our future patients will be at risk. As an example, in The Netherlands, they try to implement reusable diapers and incontinence material; but what do we do with the [ feces ]? Can we even clean absorbable materials like these? Do we want a non-absorbable? I think we should use biodegradable materials, but who is doing that work? Where in our hospitals designed for waste disposal are they doing it? Is safe cleaning even possible? And how do you implement a switch?”
Voss continued,“ So, before you say I am anti-green, I say if you can’ t beat them, join them, as many sustainability-focused projects are helpful and needed, but IPC must be in charge of setting the limits, and that is not the case in many situations. Coming back to the acceptance of rules: as you know, not everyone in healthcare is a big fan of us in IPC; the general public assumes that healthcare workers obey the rules and there is no need for supervision. Healthcare workers see us as the sheriffs; we are running around telling them what to do, what not to do, and we do not have the best image within healthcare and in this post-COVID era, we must find the right style of communication; it’ s about education and motivation and setting good examples for those around us.”
Voss addressed the impact of artificial intelligence on infection prevention and control.
“ Are AI and related technology solutions to IPC-related problems?” he asked.“ Could AI provide generative guidelines for IPC? Could we have automatic updates based on new publications or epi data? And could chatbot functions assist us? We could have predictive modeling, showing contamination of medical equipment based on user data, cleaning methods and past cleaning challenges, so you know where to look and what to address and mitigate. You could focus your money earmarked for cleaning by simply engaging in process optimization; for example, asking ChatGPT‘ What are the surfaces with the highest risk?’ and then you have a list of the things to keep in mind when focusing on that area of IPC. This kind of process will improve over time, I think. I believe that high-tech solutions are only affordable as part of a holistic approach to patient safety. We must coordinate with other medical specialties who want to use the same technology because just securing it for IPC-related purposes would be cost-prohibitive for most facilities. You could make your electronic medical record system smarter by including AI to support IPC. I would like to see messages to IPC such as‘ Patient Janssen was admitted to the ICU, he’ s a known carrier of MRSA and CRE,’ and then an emergency alert that‘ the ER dude forgot about isolation precautions again and IPC needs to address it.’ I think a system like this would help us have a better grip on what’ s happening within our hospitals. And then it could help you do a diagnostic; for example, you fill in information about a patient’ s sputum and the system would automatically tell you if this patient had fever, cough, chills, shortness of breath and malaise. It could prompt us to consider adding a test for PRP and sending an alert about isolation – these are all things that could be done easily from a technology perspective.”
Voss acknowledged the barriers associated with AI and observed,“ The problem is that AI makes a lot of things possible, what we thought would be impossible and we couldn’ t do, but all these observations and alerts and responses – why don’ t we just do them ourselves? It’ s maybe because there is a huge implementation gap that makes a lot of things impossible due to data-integration issues, lack of knowledge and communication between technology and people, regulations, finance, privacy laws, etc. So, we fall short on these things in the meantime, and we have to wait, but I think it will come, and it will really change infection control and healthcare as we know it today.”
He added,“ There is a piece in The Lancet Gastroenterology that AI tools make doctors worse at performing their jobs. In a few months after introducing AI to analyze pictures of colons during colonoscopies, people lost their skills to identify growths on their own. So, we must ensure that if we use AI, we must keep up our skills. The other issue is healthcare reform, with a growing shift of acute and long-term care closer to home-based care, and there will be new players and issues entering the marketplace, companies like Microsoft and Google and Amazon, entering healthcare and
nov-dec 2025 • www. healthcarehygienemagazine. com •
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