COVID-19 and Rising HAI Rates — Where Do We Go From Here?

The COVID-19 pandemic has taught us so much. It’s transformed our awareness of cleaning and disinfecting and raised expectations for both clinical staff and the general public. It’s been a learning curve for us all, and many of us underestimated the longevity of the COVID-19 battle.

So, what do our leaders need to do now? As vaccinations are being administered and businesses are reopening, is most of the hard work behind us? Can we finally let up on the gas and take a breather? 

Unfortunately — no.

Now is the time that we must push harder. We must take all the lessons learned and reevaluate our current infection prevention strategies. As the new delta variant and other unknown viruses continue to challenge our current approaches to infection prevention, we as leaders should devote the necessary resources to develop a sustainable long-term solution.  

The Rise of HAI Rates

A recent press release published by The Society for Healthcare Epidemiology in America (SHEA) stated that after several years of declining healthcare-associated infection (HAI) rates, there are new trends that show significantly higher rates in four out of six routinely tracked infections.

The press release goes on, stating that “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.”

Has COVID-19 contributed to the rise in HAIs? It appears as if that’s the case. The increase in length of stays, staffing issues, employee burnout, and hospitals reaching peak capacities are all effects of COVID-19 and are critical factors that impact HAIs rates. 

What can be done in light of these ongoing challenges?

This is not a time to blame others, but rather a time when we need to pull together and work as one team. By combining multidisciplinary teams, we can collaborate to implement effective infection prevention strategies.

Reducing HAIs should not just be centered on the practices of our doctors, nurses, or environmental services staff, but it should be about collaborating and building teamwork with one common goal — saving lives.

There are numerous approaches to reducing HAIs, but we’ll focus on a few that will make the most significant impact — vaccinations, hand hygiene, respiratory hygiene, and environmental hygiene. 

Vaccinations

We should continue to educate our staff and communities on the importance of getting vaccinated and every person’s contribution in helping end this pandemic. The CDC offers some helpful resources on the COVID-19 vaccine, including some valuable effectiveness research.  

Hand Hygiene

Most people working in healthcare have been taught the importance of hand hygiene, so why is compliance still an issue? Here are some of the reasons why people don’t follow good hand hygiene: 

• Dries out their hands
• Accessibility to sinks or sanitizers
• Forgetfulness
• Short staffing
• Patient priority needs
• Too busy
• Lack of knowledge on expectations  

What can be done to combat these excuses?

We need to stop merely saying that we need to improve hand hygiene but actually begin taking action. 

As leaders, we must promote a positive hand hygiene campaign. This can be done by:

• Holding discussions and reminders about the importance of hand hygiene during team meetings
• Posting visual signage throughout the facility, especially inpatient care areas
• Sharing compliance statistics
• Evaluating accessibility to hand sanitizing stations
• Implementing a sustainable hand hygiene monitoring program

When the team has hand hygiene on top of mind through continual communication about the topic, the results equate to saved lives and a reduction of HAIs. 

Respiratory Hygiene

Emphasizing respiratory hygiene (or etiquette) can also play a significant role in reducing HAIs. The COVID-19 mask requirements have made a positive impact on reducing respiratory infections. But we also need to make sure that tissues, hands-free waste receptacles, and sanitizers are readily available throughout the facility — as well as spaced seating in all waiting areas, especially in the ER.  

Environmental Hygiene

Hospital environmental hygiene starts with the right leadership — or service provider — capable of delivering a comprehensive training program, programmatic approach, evidence-based disinfecting methods, EPA approved disinfectants, and validation systems to ensure compliance — such as ATP testing or fluorescent marking devices.

Here are a few ways you can improve environmental hygiene at your hospital.

1. Leverage new and innovative technology

Implementing new innovative technology, such as electrostatic sprayers, can improve environmental hygiene. 

Electrostatic sprayers deliver electronically charged droplets that are attracted to surfaces and are able to get to hard-to-reach areas. This technology provides efficiencies when disinfecting large areas and improves disinfectant coverage on all surfaces. 

Before selecting a device, make sure the machine and chemical have EPA approval to be used together. 

2. Implement floor care best practices

Floors are breeding grounds for bacteria and infectious diseases. And neutral cleaners and weekly disinfection cleans won’t help kill harmful disease-carrying organisms from your floors. A best practice is to use hospital-grade disinfectant on all floors where patient care is delivered — daily. 

3. Proactively address staffing challenges

Do everything you can to prevent staffing challenges from getting in the way of proper cleaning procedures. Cross-training other facility personnel is a great way to address this and proactively overcome any potential short-staffing challenges. Cleaning and disinfecting must be done properly no matter what labor challenges a facility is facing.  

Another helpful tip is to be flexible with schedules. Don’t shy away from hiring more part-time employees to fill staffing needs.

4. Increase disinfecting frequency

Increasing disinfecting frequencies in critical care units or high-risk areas is a great way to fight against HAIs and ensure a clean, hygienic environment. It’s also important to implement validation systems to ensure cleanliness. Some examples include ATP testing, fluorescent markers, and frequent visual inspections — see the CDC’s list of validation best practices for reference.

Conclusion

The current pandemic has undoubtedly tested the healthcare industry, and has, unfortunately, had a negative impact on HAI rates. 

COVID has been eye-opening, and our experience throughout the pandemic stands as a constant reminder of just how fragile the environment of care is and the importance of staying diligent in our infection prevention strategies. Keeping infection prevention at the forefront of everything we do will ensure a safe place for patients to heal and, most importantly, save lives.