The healthcare landscape changed enormously in 2020 when all healthcare workers had to work differently due to SARS-CoV-2. Infection prevention and control (IPC) nurses were the most involved in this domain. Expertise in IPC was in high demand and, with the many waves of the pandemic between 2020 and 2022, SARS-CoV-2 had a significant influence on the IPC team at my Trust.
There was a requirement for all healthcare staff to be trained in donning and doffing personal protective equipment (PPE). The pandemic put pressure on the IPC team and the Trust as a whole, and increased the workload of the IPC team.
The ongoing staff absences due to the waves of infection had an impact on the rates of healthcare-associated infection (HCAI) and good IPC practice.
Robust standards
In March 2020, in order to accommodate COVID-19 intakes, there was pressure to release NHS beds. Elevated COVID-19 rates affected the admission and discharge of patients. The hospital bed management team and the IPC team collaborated closely and worked as a single team to ensure that patients were managed in compliance with robust IPC standards. The IPC nurses assisted in guiding decision-making through daily COVID-19 IPC huddles.
To protect the patients, the IPC team also put in place limits on hospital visitors and developed improved infection control measures. These persisted throughout the months of 2021 as the nation dealt with fresh waves of COVID-19.
The practice of ‘cohorting’ patients with the same infection reduced the spread and controlled outbreaks. Good IPC practices were put in place by the IPC nurses in the hospital's clinical and non-clinical areas. To ensure the safety of personnel and patients they modified policies to correspond with the government's frequently updated guidance. This was achieved despite obstacles to effective infection control, such as the design of some hospital facilities, which restricted patient flow, and personnel shortages within the IPC team that reduced staff effectiveness.
Infection prevention and control information and training were provided by the IPC team on the use of PPE. The team also made sure staff members had undergone FFP3 mask-fit testing and necessary IPC donning and doffing training. In addition, the team visited the wards every day to review IPC procedures.
Having a dedicated IPC team was crucial to the Trust's effective infection prevention: the team supported employees, monitored IPC procedures, set priorities and reduced risk.
To ensure that any IPC issues were handled and guidance followed properly, a no-blame culture was essential. A supportive atmosphere was developed via an all-team approach to IPC. To ensure that patient safety was the top priority, this entailed co-operating and constructively engaging with colleagues from across the Trust, including with non-clinical workers.
Staff members felt informed about IPC protocols and modifications because of an effective and prompt information cascade. The IPC team used a range of channels to interact with hospital personnel, including staff intranet pages, posters, bulletins and social media.
Each patient and department had a COVID-19 risk assessment conducted by department staff and the IPC team respectively. Assessments of staffing, pathways, and individual risk were also carried out. Elective pathways underwent a thorough risk assessment, which also looked at the environment and staffing.
‘Having a dedicated IPC team was crucial to the Trust's effective infection prevention – they supported employees, monitored IPC procedures, set priorities and reduced risk’
Training
IPC nurses identified, investigated, and contained infection outbreaks. They also worked with the doctors to monitor all units by keeping track of healthcare staff compliance with IPC. Programmes were implemented using frequent audits and consistent reporting. IPC nurses actively engaged in education in this setting, as well as in formal and informal training programmes for all health professionals.
As SARS-CoV-2 spread around the world, the focus was diverted from other infections in favour of understanding and containing the novel coronavirus. The IPC team continued to manage any other infections that arose, along with COVID-19 outbreaks. Additionally, we implemented localised approaches for enhancing IPC, such as creating departmental IPC champions and producing illustrated in-service training instructions.
Hospitals and their IPC programmes were burdened by an increase in the number of inpatients, supply chain interruptions, high infection rates, and healthcare infrastructures. Any existing challenges became more difficult.
The IPC team continues to emphasise the importance of each staff member's personal responsibility for implementing and upholding IPC principles and practices as part of their duty of care.
I was pleased to receive a Bronze Award in the Infection Prevention Nurse of the Year category of the BJN Awards 2022. Even though I personally received the award, it is dedicated to our entire IPC team at my Trust. I am reminded of an old quote that says teamwork is ‘the result of individuals that have worked together to effectively and efficiently achieve organisational tasks and vision and mission’.