Even if the COVID-19 pandemic ends soon, surgery centers likely will need to maintain the same level of infection prevention vigilance they have practiced for more than a year.

“I wouldn’t say indefinitely, but personal protective equipment [PPE] will be here for a long time,” says Denise Ricketts-Goombs, RN, MPH, CIC, a consultant in infection control, risk management, quality improvement, and patient safety in Wellington, FL. “Even as patients are vaccinated, and even with a vaccinated staff, there is still a possibility that there could be infection. Because someone is vaccinated, you won’t use less of a precaution, so I think we’ll see the use of high-level PPE for a long time.”

“Organizations have had a year or more of experience now in terms of how to safely provide care to their patients and to also have a safe environment for clinical and medical staff,” says Frank Chapman, MBA, director, strategic planning for Ohio Gastroenterology Group, Inc. in Columbus. “When this virus broke out in 2020, we saw that organizations updated infection prevention and control plans and risk management plans. Evacuation plans also have had to change because you don’t want tight groups of people evacuating a building.”

As conditions changed and new information became available, surgery leaders refined processes along the way. What may have seemed unusual one year ago likely has become the new normal to staff and patients. “I think that process, depending on what they’re doing and the population of patients they’re seeing, would be applicable whether or not a new COVID variance causes a spike in cases,” Chapman says. “It is something we probably should have been doing all along.”

Pointing to national data showing record low levels of influenza cases in the United States, Chapman notes wearing PPE and practicing more stringent infection prevention techniques has made patients safer than they were before the COVID-19 pandemic. The CDC reported in mid-February that patient visits to healthcare providers for influenza-like illness were down to about 1.1%, compared with a previous national baseline of 2.6%.1

Hand hygiene, always an important part of infection prevention, has been especially important during the COVID-19 pandemic. “Since the pandemic, I have seen an increase in compliance in hand hygiene among the centers that I visit,” Ricketts-Goombs reports. “The reason why is that people are more aware and more concerned with regard to COVID-19.”

These infection prevention improvements and staff compliance with those updated policies show surgery centers have learned a great deal about better ways to provide a safe environment for patients and staff.

“When the pandemic does abate, I do hope that most centers maintain this high level of attention to hand hygiene and infection control methods,” Chapman says. “In the past, especially in nonsterile environments, a surgery center’s practices might be lax when compared with the sterile environment. I think everyone has had to step up their infection prevention practices.”

Another prevention practice that has greatly improved is surface disinfection. “Something even as basic as surface cleaning — we’ve upped that. That’s something we should have been doing all along,” Ricketts-Goombs says. “There are infections like hepatitis and MRSA that stay on surfaces. Because we didn’t have as rigorous of cleaning before, patients or employees could acquire infection. It’s advantageous to maintain the meticulous cleaning.”

Moving forward, there are other ways to maintain and improve infection prevention practices:

Clear communication. “Some surgery centers have a COVID team, and that team is responsible for making sure they follow all updates and executive orders,” Ricketts-Goombs says.

Whether a surgery center employs a COVID-19 team or infection prevention team, this group can help staff maintain best practices through clear communication.

“One best practice is to have a pandemic binder with someone responsible for updating the information,” Ricketts-Goombs says. “Every week or so, there have been new recommendations, so an updated binder can be the one source of truth where employees or physicians can go to see what are the most up-to-date recommendations.”

It is important for leaders to maintain open lines of communication with the staff so they feel comfortable approaching administrators to discuss their concerns.

Additionally, the infection prevention team can celebrate successes, such as X number of days with no infections, and encourage staff to keep up best practices.

Seek professional help. “Access to professionals in infection prevention and control is extremely important right now,” Chapman says.

For example, the AAAHC asks managers who oversee prevention programs receive specific training in infection control. “It’s valuable to get a second set of eyes on policies and procedures,” Chapman says. “To have access to an expert is extremely important in times like this.”

Encourage staff to become vaccinated. Even among healthcare professionals, there has been some vaccine hesitancy. Surgery center leaders need to encourage staff to become vaccinated as soon as they are eligible.

“The sooner more people get vaccinated, the sooner we can get to that point where we’re looking for that normal life again,” Ricketts-Goombs says.

Review policy and procedures often. Typically, risk management, infection prevention, and other safety procedures were reviewed annually — until the COVID-19 pandemic. Now, that guidance should be reviewed and updated much more often.

“Once a year is inadequate right now,” Chapman says. “Things have to be fluid. You will need to look at your infection prevention and control processes and other surgery center activities more often.”

If there is a necessary change, it should be made immediately. “Don’t wait for the quarterly board meeting,” Chapman suggests. “Surgery centers need to be nimble.”

Leaders must adapt to the latest science and make changes as soon as possible. Once the change is made, surgery center leaders should educate staff and refer them to resources with additional information, such as a COVID-19-centric binder that is easily accessible.

“If it’s not communicated to staff, it doesn’t make sense,” Ricketts-Goombs cautions. “They should have documentation, either electronic or on paper, that shows the changes have been communicated to employees.”

REFERENCE

  1. Centers for Disease Control and Prevention. Weekly U.S. influenza surveillance report. Page last reviewed Feb. 19, 2021.