Improved patient outcomes and collaborative care through infection prevention and control

Issue: January 2016

ByLouise-Marie Dembry, MD, MS, MBA, FSHEA

As we reflect on the field of infection prevention and control for 2015, we have elevated the urgency of the attention paid to infection prevention especially as it relates to stemming antibiotic resistance, both within health care facilities and in the broader community — with the buzzword being stewardship.

Federal officials have embraced antibiotic stewardship, placing a renewed interest on stopping misuse of antibiotics. The White House established the National Action Plan to Combat Antibiotic Resistance, which enlists players from across industries, including health care and agriculture, government and advocacy, to come together in a coordinated effort to stem inappropriate use, protecting the efficacy of antibiotics and preventing serious infections for patients. Yet the strongest stewardship programs run in tandem to strong infection prevention programs.

In addition, CMS has focused on the need to reach beyond acute care settings, with an anticipated rule establishing antibiotic stewardship programs and stronger infection prevention programs as a requirement for long-term care facilities to participate in Medicare.

While we have made significant progress, the field of infection prevention still has issues to address as well as opportunities to pursue as we work to sustain the momentum in reducing the prevalence of health care-associated infections. Here are some of our key issues for 2016:

Limited resources: Health care budgets are increasingly strained by competing priorities. C-suite leaders must make tough decisions to ensure institutions remain financially viable. However, investments in infection prevention are crucial for reducing the number of infections and improving patient safety. The critical behind-the-scenes work of our teams goes far beyond that of hospitals’ quality and safety departments, yet our efforts often remain under the radar. While our value is sometimes overlooked, we must remain vocal and enlist champions to help leadership understand how epidemiology experts are a crucial part of the care team. Our expertise cannot be substituted by quality improvement/management staff.
Teamwork among specialties: Our mission requires collaboration, so we must continue fostering and strengthening relationships with other specialties to make evidence-based interventions a priority. For example, we can raise awareness of surgical-site infection prevention by working more closely with our surgical colleagues and operating room staff. Because care teams are increasingly multidisciplinary, it is important to ensure that stewardship programs reflect the differing perspectives from the front lines of care, including pharmacists, nurse leaders and laboratory staff.
Recognition of infectious diseases professionals in all settings: From long-term care to academic and community hospitals, the work of professionals in epidemiology cuts across the span of health care settings, each of which has unique issues. The Society for Healthcare Epidemiology of America (SHEA) looks to unite these perspectives and to give voice to all in health care to share their opinions and spread awareness of the challenges and best practices that arise in their particular specialty and practice setting.
Preparedness for emerging infections: An outbreak of an emerging infection is always lurking. Over the years, health care epidemiology experts have led the response to severe acute respiratory syndrome, Middle East respiratory syndrome, pandemic flu, enterovirus-D68 and Ebola, including the investment in preparing for possible outbreaks at U.S. health care institutions. Emerging pathogens demand ongoing resources to monitor, plan and train for future emergency scenarios. If we wait to prepare for the next threat, it could be too late.

Everyone has a role in infection prevention. Health care epidemiologists and infection prevention staff, as content experts, must continue to emphasize that infection prevention is everyone’s responsibility — health care personnel, patients and their families — and remains a vital factor in every patient’s care. This concept supports SHEA’s vision of “Safe healthcare for all.”

For more information:
Louise-Marie Dembry, MD, MS, MBA, FSHEA, is president of the Society for Healthcare Epidemiology of America, professor of medicine (infectious diseases) and epidemiology (microbial diseases) at Yale School of Medicine, and director of hospital epidemiology, VA Connecticut Healthcare System.

Disclosure: Dembry reports no relevant financial disclosures.