Three critical challenges facing infection prevention and control programs include:
1. Emerging pathogens and antimicrobial resistance
Emerging infectious diseases can spread rapidly and gain momentum to become endemic in certain areas or cross international boundaries, as most recently demonstrated with the COVID-19 pandemic. Antimicrobial-resistant infections can also quickly spread and are proven to be difficult, if not impossible to treat. Newly emerging infectious diseases, including but not limited to those pathogens conferring resistance often initially present with very little information on their modes of transmission, how to best detect/diagnose them, how to treat them, and how to reduce susceptibility.
This introduces significant challenges for programs aiming to implement best practices to prevent and control spread. In addition, emerging infectious diseases pose a significant risk to everyone, including healthcare workers, while information is still being discovered on how to best protect individuals and prevent exposures. In these scenarios, facilities must be prepared to respond quickly to protect the safety of all persons within the healthcare environment.
2. Healthcare facility resourcing
The emergence of global pandemics and other large-scale emergencies have repeatedly highlighted an urgent need for healthcare facilities to maintain medical surge preparedness and surge capacity around the world. A medical surge occurs when the needs of clinical and/or patient volumes exceed the facility’s service limits. Surge capacity can be comprehensively defined as “the ability to obtain adequate staff, supplies and equipment, structures and systems to provide sufficient care to meet immediate needs of an influx of patients following a large-scale incident or disaster.”
Staffing challenges
Inadequate staffing due to shortages or high turnover can lead to unmanageable patient volume, delays in care, or staff burnout. These factors promote serious barriers around patient safety, positive outcomes, efficiency, and healthcare worker satisfaction.
Access to medical supplies and equipment
Lacking supplies or equipment hinders the healthcare worker's ability to provide safe and effective patient care. Ample supplies such as gloves, masks, gowns, and appropriate environmental disinfectants help to prevent the spread of infectious diseases among patients and staff. The reasonable availability of medical devices, diagnostic tools, medications, and other resources ensure the provision of timely and accurate patient care.
Infection prevention processes and systems
Adequate and competent systems, including IP programs and process improvement efforts support the hardwiring of error reduction, improve outcomes, as well as promote highly reliable care. The establishment of this type of program encompasses all the projects and team activities an organization implements to achieve its goals. When programs are built and equipped to handle all the complexities, risks, and costs that come with modern healthcare, it's able to optimize the replication of best practices and the avoidance of error. When it comes to infectious diseases specifically, Infection Prevention and Control (IPC) programs must be standardized and robust to respond promptly and effectively.
3. Surveillance and reporting requirements
IPs must be knowledgeable about the various agencies and regulatory entities that oversee/publish standards for healthcare-associated infections (HAIs). These bodies include the National Healthcare Safety Network (NHSN) as part of the Centers for Disease Control (CDC), the Centers for Medicare and Medicaid Services (CMS), and state and federal health agencies.
Given the scope and complexity of IPC surveillance, it has been estimated that 45% of IP time is consumed by this activity. It's also estimated that an unsustainable proportion of surveillance activities continue to be performed manually, as opposed to leveraging some sort of automated system. Manual surveillance activities demand more time and are prone to errors which negatively impact process improvement and IPC program effectiveness. In addition, manual surveillance processes leave IPs with less time for other patient safety efforts that may be equally if not more, important.
The use of a sufficient automated infection prevention surveillance software system should facilitate data collection, reporting, and analysis burdens in real time. Maintaining an automated program for IPC surveillance and reporting improves accuracy, ensures time efficiency, and should be classified as a requirement for any highly reliable and effective IPC program.
Fifty years of IP evolution has brought us to a crossroads in which we face increasingly diverse and complex issues. IPC programs are faced with navigating a constantly changing healthcare landscape while also needing to maintain reliable evidence-based approaches at the same time. This summary focuses on healthcare facilities; however, it’s critical that advances are also made to improve IPC efforts across the larger continuum of care as well as within national and global public health sectors.
