There's a plethora of factors propelling the upward trend of hospital-acquired infections and outbreaks, meaning hospitals' prevention efforts need to be complex, too, experts told Becker's.
What happened
The COVID-19 pandemic strained and transformed healthcare operations in multiple ways. Some employees contracted and died from the virus, so healthy staff worked longer hours and picked up extra shifts, thus exacerbating burnout and early retirement. Hospitals also recruited workers into their first-ever COVID-19 units as experts raced to determine how best to control spread before knowing how the virus would evolve.
"People were terrified. And when you're terrified, you're often not at the top of your game," said David K. Henderson, MD, a senior consultant to the hospital epidemiology team at Bethesda, Md.-based NIH Clinical Center.
The habit of reporting HAIs and enacting basic infection control practices slid off priority checklists as the nation's healthcare system "was really overwhelmed with the crushing volume of the pandemic," Erica Shenoy, MD, PhD, the chief of infection control at Boston's Mass General Brigham, told Becker's.
As supply shortages forced workers to reuse N95 respirators and disposable eye protection, work was too busy for infection control experts to patrol and audit practices in biweekly bedside rounds, Dr. Henderson and Dr. Shenoy said. At the same time, antibiotic resistance grew.
What's happening
As the COVID-19 pandemic pinched healthcare, a mold-related event from a humidifier killed seven patients between 2001 and 2020 at Seattle Children's Hospital. A few years later, nine have died amid an ongoing bacterial outbreak at Seattle-based Virginia Mason Medical Center. The two outbreaks are unrelated, but one city reporting fatal HAI outbreaks within a few years is "not unexpected," according to Michael Osterholm, PhD, director of the Center for Infectious Disease Research and Policy at Minneapolis-based University of Minnesota.
"In fact, we're going to see more and more of these situations," he said. "Probably, the most dangerous place someone can be in terms of acquiring infection is in a hospital. You don't want to be in a hospital a day longer than you have to be. That may come off sounding like it's a very negative thing about hospitals, it's not: It's just the reality of today."
What needs to happen
Many hospitals are working to reboot fundamental infection control practices, Dr. Shenoy said, but each facility needs to measure and focus on which HAIs present the biggest threat.
Dr. Osterolm said there needs to be structural support from multiple teams. He recommended infection control leaders employ chief medicine and nursing colleagues to help enforce infection control practices on a routine basis.
"When you don't even have enough people to work in your janitorial staff, let alone provide training for them on a routine basis, again, [it's] just another additional challenge with regard to infections acquired in the hospital," he said.
Dr. Henderson shared similar advice, adding that leaders need to be more vigilant in educating and enforcing these fundamental practices among new staff.