The age of virulence: Sustaining an effective infectious disease preparedness plan

October 17, 2022

There are many external factors affecting healthcare organizations' infection preparedness plans in the "age of virulence", including the eventual expiration of the COVID-19 Emergency Declaration, OSHA's continued focus on permanent infection control standards, staffing shortages, limited availability of infection preventionists, at-risk patient populations and economic uncertainty.

In this webinar, attendees will learn about the potential impact of the Emergency Declaration expiration and how to develop staff to become infection preventionists, while reviewing sharps injuries and injection-site safety and recommendations for infection prevention.

Presenter:

Brian Williams, vice president of compliance and learning, MedTrainer

Learning objectives:

Describe the impact of changes to federal and state regulations upon the expiration of the COVID-19 Emergency Declaration
Become familiar with the role of the infection preventionist and the need to have leadership commitment for an effective infection control & prevention program
Identify the regulatory requirements and practical application for the sharps safety program
Adapt current recommendations from reliable resources.

Key topics:

Minute 1:15 – Overview
Minute 2:10 –Review "The age of virulence," part I
Minute 2:45 – Public Health Emergency expiration
Minute 6:05 – Health equity consequences
Minute 8:45 – National Special Pathogen System (NSPS)
Minute 10:40 – Telehealth implications
Minute 15:40 – The role of the infection preventionist
Minute 2 :05 – Sepsis & antibiotic resistance
Minute 26:07 – Regulatory requirements & sharps safety
Minute 40:30 – Adapting recommendations
Minute 45:00 – References and resources

Creating an effective pandemic preparedness plan in the age of virulence

Healthcare has entered an age of virulence, says Brian Williams, vice president of compliance and learning at MedTrainer®, which he defines as the emergence of multiple, simultaneous zoonotic infectious diseases and healthcare disasters.

And while he says an effective pandemic preparedness plan is possible in this scenario, healthcare organizations must be aware of the external obstacles that make it a tricky undertaking.

In our July 20th webinar, Williams spoke on the various challenges today's healthcare practices face regarding adequate infection preparedness. He also provided some smart solutions for how to move forward, including the importance of hiring on-site infection preventionists.

Read on for a quick overview and check out the above webinar for a more in-depth look at the topic.

Adapting to the age of virulence

Aside from the age of virulence, Williams mentions other relevant factors impacting healthcare organizations' infectious disease and pandemic preparedness plans, including:

The eventual expiration of the COVID-19 Emergency Declaration
OSHA's prioritization of permanent infection control standards
Healthcare staffing shortages, including limited availability of experienced infection preventionists
At-risk local and global patient populations
Economic uncertainty

It's a lot to consider, but acknowledging the age of virulence and all that comes with it is essential to designing an effective pandemic preparedness plan, especially as we move forward into the post-COVID and post-antibiotic eras.

How to create a better pandemic preparedness plan

COVID-19 and previous pathogenic emergencies like Ebola, MERS and AIDS forced healthcare practices to rapidly enact their pandemic preparedness responses. In doing so, these outbreaks shined a harsh spotlight on the many inadequacies behind those responses, particularly regarding organizational consensus and infection stewardship.

According to Williams, rather than looking at these outcomes as a failure, the lessons we can take from the experiences may be applied to the many challenges ahead. First and foremost: generating more awareness of the need for an ironclad, evidence-based infectious disease preparedness plan and building an adaptable support system to implement that plan.

Here are the four steps he says are key to making that happen:

1 | Review changes to federal and state regulations related to the COVID-19 emergency declaration expiration

The Public Health Emergency (PHE), established in late January 2020 and most recently renewed in July 2022, resulted in changes to federal and state healthcare regulations – some of which will phase out once the PHE officially expires.

Perhaps the most problematic change in relation to overall infection prevention will be the stark drop in healthcare eligibility, with many millions of people expected to lose Medicaid coverage.¹Other safeguards, such as expanded access to telehealth services and COVID testing and treatment without patient cost-sharing, are also due to change.

Healthcare organizations should review and modify existing infection prevention practices in light of these and other impending regulatory adjustments. Since states vary widely on post-PHE payment policies, they should also look carefully into location-specific regulations and their potential impact on pandemic preparedness in the months and years to come.

2 | Become familiar with the role – and necessity – of the infection preventionist

A designated infection preventionist is crucial to an effective infection control and prevention program. These individuals:

Collect and analyze data trends
Implement evidence-based infection control strategies
Help educate and train licensed and unlicensed staff
Ensure compliance with regulatory and licensing agencies
Are a first-line defense against emerging outbreaks

Williams notes that the level of expertise required from an infection preventionist depends on the size and complexity of the organization they represent. However, the widespread need for leadership commitment to ensuring the role is filled doesn't change.

Regardless of scale, all healthcare organizations must recognize the importance of infection preventionists for infectious disease preparedness, investing in both the position itself and the resources needed for the preventionist to do their job.

3 | Identify regulatory requirements and practical applications for sharps safety

More than 20 pathogens are transmissible through sharps injuries.²These types of injuries are largely preventable with a thorough sharps safety plan.

Williams recommends that organizations review their sharps safety plan annually, accommodating any shifting regulatory requirements. In addition to optimizing their plan for the prevention of sharps injuries, organizations should also have clear and up-to-date protocols for what to do at the time of exposure and post-exposure.

Various necessities of a sharps safety plan include mandatory reporting of all exposures to a supervisor and immediate treatment for infection control. After this period, the source of exposure should be identified and examined and blood samples of impacted staff should be collected.

4 | Adapt universal recommendations to facility needs

Standard universal precautions don't always resonate with all healthcare facilities, Williams says. Infection preventionists and their teams must take into account organizational context when coming up with an infectious disease preparedness plan, such as the type of care setting and the risks, needs and desires of individual patients.

Ultimately, Williams says, the goal is to act defensively against infection, playing chess rather than checkers with best practices like:

Surveillance
Environmental contamination control
Diagnostic stewardship
Infection prevention standardization

To conclude, healthcare organizations must develop practical and enforceable plans for their facilities, making ample use of reliable internal and external resources to ensure their strategy is strong.

Listen to the webinar for a full explanation of these and other recommendations to stay a step ahead of the dos and don'ts of pandemic preparedness in the age of virulence.