As we look back at the last 18 months, it is astonishing to see the changes that have occurred in healthcare. Throughout the last few years, we have survived severe epidemics and wondered not if, but when, the next would occur.
Unfortunately, most were not expecting COVID-19, which quickly rose to a pandemic and continues to be a threat all over the world. With the pandemic, shortages have occurred in hospital bed availability, employee resources, equipment, personal protective equipment (PPE), patient care supplies, cleaning supplies and medications. Not only were there medication shortages, but many had to be developed, including the current COVID-19 vaccinations. It would have been near impossible to project the challenges that we have faced in healthcare and society.
The pandemic resulted in the provision of healthcare in ways we could not have imagined. As healthcare providers, the changes that needed to be made often coincide with the processes and culture that everyone was trained to do for so many years. The conservation of PPE, including the reuse of masks, cleaning gloves and many other examples have been staggering, especially to infection preventionists. If asked prior to the pandemic, most infection preventionists likely would have never agreed to the processes that today we perform out of necessity. Although we have seen some improvement in the availability of many supplies, it is still vital that everyone understands that the shortages are not over and with COVID cases increasing again at press time, we could be returning to a similar situation that we experienced during 2020 and early 2021.
Retain the fundamentals
It is vital to continue meeting regulatory standards and guidelines during this crisis and not sacrifice patient care and patient safety. Everyone is learning how to perform tasks in different ways and with various resources. Keeping this in mind, it is important to strive to comply with these standards and make every attempt to get back to the basics of patient care delivery.
Now, as many facilities are beginning to reopen, they will face challenging times and many issues that need to be overcome. Procedures and elective surgeries will increase. Questions will arise regarding COVID testing of patients prior to procedures and surgeries. Will the facility allow visitors and, if so, with which patients and how many? What will visitation processes be?
Infection prevention practices should always include hand hygiene, appropriate PPE, OSHA standards compliance and adherence to CDC guidelines and regulatory standards. If changes were made related to PPE or other resources, it is important to return to standard compliance as soon as possible. For example, most facilities can obtain PPE more readily than before, so it would be appropriate to cease reusing or disinfecting masks – particularly if mask availability has increased.
Regardless of pandemic protocols, it remains critical to ensure cleaning, disinfection or sterilization of instruments is performed according to guidelines. OSHA standards for the transportation of contaminated instruments should be followed. The organizational policy for the appropriate handling of contaminated instruments should follow the standards and guidelines. If it does not, the policies should be updated, and the employees educated on the changes.
Miles to go
The pandemic is not over yet. Going forward, it is important to evaluate lessons learned and strategically plan how to correct mistakes during this pandemic in preparation for the next surge, pandemic or crisis. There are many opportunities that can be addressed. Corrective action plans should be developed.
Conduct meetings with the front-line employees to learn real-life experiences and what could have been done differently. Organize team meetings and activities in all departments. It may be surprising to learn the struggles the employees have overcome and to listen to their suggestions for long-term solutions. Sometimes the front-line employees are forgotten or overlooked in problem-solving activities when the entire facility is in an emergency state. Often, there are simple solutions to large problems when employee input is solicited.
A high-reliability organization will take a proactive approach to solve the issues that are in their direct control and look for solutions to address the ones that are not. One thing is for sure, when this pandemic is over, another one is on the horizon!