Key Take Aways
- Nurses are more important than ever.
- Nurses are primarily responsible for the implementation of isolation practices.
- Innovative approaches are needed when managing infections requiring isolation.
- Adjust workload measurements to accommodate infection prevention and control procedures.
- The classic debates (1) on transmission route and (2) on special isolation techniques may not matter in the face of insufficient clinical resources.
- Nursing and clinical healthcare support staff are needed in sufficient numbers now more than ever.
The COVID-19 pandemic accelerates changes already underway in the healthcare workplace. In our present situation, the complexities of caring for patients with infectious co-morbidities have increased exponentially, and the potential impact on the job functions of clinical staff and healthcare workers has never been greater.
That said, our US-based healthcare workers already know how to handle infectious disease. Prior to our current pandemic, the daily work of healthcare professionals has been impacted by the worldwide increase in Methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, and Clostridium difficile.
The recent COVID-19 pandemic is stretching our healthcare system’s ability to cope. According to a recent scientific study by Kaba et al. (2017), there are at least three main impact areas:
- The daily work of healthcare staff has been impacted by an increased and increasing number of infections requiring isolation.
- Nursing care and healthcare in general has expanded to include the management of multiple infectious diseases, often overloading healthcare staff and creating backlogs.
- A 2017 case study in the American Journal of Infection Control suggests innovative approaches are needed when managing infections requiring isolation – including adjusting workload measurements to accommodate the increased time necessary for infection prevention and control procedures.
Unfortunately, hospital and healthcare systems are often resistant to process or procedural change. In fact, the proverbial timeline between a discovery and the implementation of said discovery in clinical practice is 17 years. In our current pandemic, this “science to service lag” could easily create significant healthcare challenges.
Backlogs and overloading of clinical staff is the inevitable result – raising concerns around the quality and continuity of care.
As Jackson and Lynch (1985) note, nurses are the persons primarily responsible for the implementation of isolation practices. In their study, two relevant themes for today emerged. First, we have not settled the transmission question establishing the importance of the airborne route vs. the importance of contact with moist body substances. And, second, we have not settled the question of whether special isolation techniques are needed for persons with diagnosed infections vs. the potential that all persons harbor potentially infectious agents.
All this said, the cumulative impact of additional infection prevention and control appears to result in trade-offs and cutting corners. Backlogs and overloading of clinical staff is the inevitable result – raising concerns around the quality and continuity of care.
So, regardless of your approach or the stance you take on the above debates, what is clear is that having sufficient personnel in place is critical. Your nursing and clinical healthcare support staff are needed in sufficient numbers now more than ever.
A descriptive case study of the changing nature of nurses’ work: The impact of managing infectious diseases requiring isolation.
Kaba A., Baumann A., Kolotylo C., Akhtar-Danesh N.
(2017) American Journal of Infection Control, 45 (2), pp. 200-202.
Isolation practices: A historical perspective
Jackson M., Lynch P.
(1985) AJIC: American Journal of Infection Control, 13 (1), pp. 21-31