Increased Healthcare-Associated Infections: The COVID-19 Impact on Hospital Infection Prevention

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Monika Pogorzelska-Maziarz, epidemiologist, health services researcher, and associate professor at Thomas Jefferson University, shares insights on COVID-19's influence in acute care hospitals at this year’s Society for Healthcare Epidemiology of America (SHEA) conference.

The COVID-19 pandemic affected acute care hospital infection prevention and control (IPC) departments, impacting staffing, resources, and standard practices. An electronic survey conducted between August and December 2023 by the National Healthcare Safety Network involved 594 IPC departments, examining these changes across 1,400 hospitals with a 20% response rate.

The findings revealed that during the first 2 years of the pandemic, 50% of the responding facilities saw increases in Healthcare-Associated Infections (HAIs). Specific increases included central-line-associated bloodstream infections (54%), catheter-associated urinary tract infections (46%), and ventilator-associated pneumonia (45%). Major factors contributing to the rise in HAIs were identified as staffing shortages (70%), higher patient acuity (69%), and the use of travel nurses (48%). There were also increases in medical device utilization (37%) and a decrease in bedside patient monitoring (31%).

“I think for the most part, in fact, what we saw in our survey, we saw that it really gave visibility to the infection prevention control department, at least in the first 2 years,” says Pogorzelska-Maziarz. “About half of our respondents reported that they had increased influence on hospital decision making and a lot more visibility.”

In response, IPC departments intensified their efforts by increasing monitoring and rounding (81%), re-educating frontline staff on IPC protocols (77%), conducting environmental care rounds (69%), and enhancing isolation compliance monitoring (66%). Additionally, 57% of hospitals formed an HAI Task Force/Committee, and over half implemented nurse-driven catheter removal and insertion prevention protocols.

“This also meant that they had less time for routine infection prevention and control activities,” explains Pogorzelska-Maziarz. “And, most importantly, staff education. So, they were spending less time on the floor interacting with staff, and more time in their offices working on policies that were ever-changing. So are real dramatic differences and how they spent their day and what they were able to do.”

The survey also highlighted that 19% of respondents felt increased pressure from management to modify HAI reporting practices during the pandemic, with 7% experiencing this pressure from healthcare providers. This study underscores the critical need for ongoing documentation and evaluation of IPC practices during health crises, ensuring hospitals are better prepared and can effectively respond to future pandemics.

Reference

Monika Pogorzelska-Maziarz. The Impact of COVID-19 on Healthcare-Associated Infections: A Survey of Acute Care Hospitals. Poster #296 presented at SHEA 2024. April 16-19, 2024. Houston, TX. https://www.jefferson.edu/academics/colleges-schools-institutes/nursing/research-innovation-office/preventing-infections-through-appropriate-staffing-study.html?utm_source=vanity&utm_medium=offline&utm_campaign=pitas

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