Infection control practices need a post-COVID update

The COVID-19 pandemic exposed vulnerabilities in how infection control is managed within the Australian healthcare system. Healthcare workers in Australia are nearly three times more likely to contract COVID-19 than the general population.

Some of the best advancements witnessed in infection prevention and control have come from retrospectively reviewing data collected during outbreaks, such as SARS 2003. It is a pivotal time for the industry to reflect on the COVID-19 pandemic and reanalyse the current approach to infection control.

During the SARS outbreak in 2003, healthcare workers in Southeast Asia created a buddy or ward-based champions system to remind fellow staff of best-practice infection control in real time. A ward champion or buddy would intervene, when possible, to prevent someone from breaching infection control measures. For example, they would make hand gestures in closed infection control environments or call out to stop that individual from touching their eyes or adjusting their mask. This type of system could also be set up to support healthcare workers in Australia.

When a pandemic hits, governments, hospitals and healthcare workers need to mobilise quickly, but key to delivering care is ensuring all frontline workers are fitted with their personal protective equipment (PPE) prior to an outbreak.

Incorrectly or poorly fitting PPE can be ineffective and create high-risk, unsafe environments for hospital staff, patients and visitors. A key practice that can be adopted is mandatory, annual fit testing for PPE. The size and brand of mask that fits each individual is unique. The mask’s seal and a person’s face shape all play a role in choosing the best-fitting PPE. Facilities could create a system for healthcare workers to carry details of their exact fit on a name or security tag. These reminders would help staff stay informed on their fit and remain conscious of always donning the correct PPE for them.

Infection control teams are often the first points of contact when it comes to PPE in the healthcare setting; however, these teams are often challenged with misinformation and conflicting advice from non-expert individuals and agencies. Small practices can be particularly vulnerable to lapses in infection protection, as there is often no single member of staff who is responsible for an infection control program. These factors all contribute to the need for everyone in the healthcare sector to be well versed in understanding PPE and the risks incorrectly worn, fitted or low-quality PPE can carry.

Misinformation can also extend to product selection. Healthcare workers should never assume that a mask does the job. The COVID-19 pandemic saw the emergence of poorly designed or even counterfeit PPE entering the Australian market. The rollout of national PPE training programs for staff in public and private hospitals as well as GP clinics could help improve education around these issues. These programs would need to include competency testing on selecting appropriate PPE as well as education on donning and doffing — including appropriate disposal.

There is a movement towards improving understanding and sharing insights from the pandemic throughout the sector. COVID-19 has triggered greater interest from healthcare workers to learn more about infection control with the emergence of new resources, like The Halyard Education Podcast Series, which support that broader education.

By looking at past outbreaks, the Australian health sector can gain insight into how to effectively prepare for future scenarios. With case numbers dropping throughout the country, it is now integral to think critically about key learnings from the height of the pandemic, including a review of how infection control can be managed to better protect healthcare workers into the future.

*Dr Cathryn Murphy has spent 33 years specialising in infection control and prevention and has worked at and with several of the world’s leading and infection control agencies and organisations over that period. These include the Centres for Disease Control and Prevention in Atlanta, the World Health Organization, as a consultant during SARS, and as a leader and president of APIC and a participant on various infection control-related committees on the Australian Commission on Safety and Quality in Healthcare.

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