Setting our IPC priorities for the next 3-5 years

In honour of Infection Prevention and Control Week (#IIPW) 2021, I thought I put up a quick post based on a talk I did on Friday last week about the ‘Future of Healthcare and of Infection Prevention and Control’ (you can download my slides here). I used it as an opportunity to put across my strategic priorities for the next 3-5 years. And COVID-19 is bottom of the list – keep reading to find out why…

As we begin to move towards a “living with covid” approach to life, what should be the strategic priorities for our IPC services over the next 3-5 years? This is what I chose, and why:

  1. Promoting antimicrobial stewardship. The COVID-19 pandemic has meant that our antimicrobial stewardship programmes have taken a hit. There’s been a lot of undifferentiated respiratory infection turning up at our hospital front doors. Many staff have been stretched and/or redeployed to other areas of the hospital. Critical care has been under extreme pressure. The result has been that the usual systems in place to moderate prescribing practices have been challenging to maintain, and antibiotic prescribing has both increase and gone in the direction of broad spectrum agents. Lots of work has been done to reverse this trend and get back towards normal, but there’s more work to be done. In 20 years time, when we will have a fuzzy memory of the COVID-19 pandemic, we will still be talking about antibiotic resistance. So, that’s why this is my #1 priority.
  2. Embedding digital systems to enhance our clinical services. There is a digital revolution afoot. The way that we run our IPC services will change over the next 3-5 years as various digital systems come online to support and extend our reach. Much of this will be centred in the electronic patient record, which facilitates semi-automated surveillance of healthcare-associated infection. This will allow us to have much better visibility of all HCAI (HAP, VAP, SSI, CAUTI, CLABSI etc), and change our IPC workflows. I expect other digital tools to come to our fingertips too: rapid genomics, better diagnostics, futuristic data visualisation (think Minority Report) and others.
  3. Preventing Gram-negative bloodstream infection. The national ambition is to halve Gram-negative BSI and I still think we can make major strides towards this ambition with the implementation of some fairly simple interventions. Improving our understanding of the sources of Gram-negative BSIs is the first step. Then optimising antibiotic treatment, especially of UTI, improving hydration across the board, and developing specific interventions in high-risk groups will all help to reduce Gram-negative BSIs.
  4. Preventing SSI. SSI fascinate me as much as they frustrate me. They are one of the most impactful SSIs, reducing patient experience, costing hospitals a large fortune, risking the reputation of our hospitals, and driving antimicrobial resistance. And we know that proper implementation of SSI prevention measures can slash SSI rates. So, SSI prevention continue to be a major focus of our activities.
  5. Preventing the transmission of SARS-CoV-2 in our hospitals. I am not saying that preventing COVID-19 is unimportant in any way. Only that it’s relative importance compared with our other strategic priorities is very likely to fade over the 3-5 year timeframe as the pandemic merges into one of the endemic respiratory viruses that we deal with.

This is a rather potted list in that it doesn’t include many other vital strategic priorities. Probably first and foremost is funding and having the right people around to deliver an effective IPC services. Followed rapidly behind by have an organisaitonal standing where people actually listen to your advice and act upon it. Without those two things, we can have the best strategy in the world, but it will do nothing to improve patient safety. We could also have training and education, workforce, mental health, sustainability, and many others.

So, over to you. How you you rank these strategic priorities for IPC over the next 3-5 years?

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