Infection Prevention: Looking to the Future While Tending to the Present
By Matt Phillion
The challenges facing infection preventionists (IP) were already immense before the COVID-19 pandemic hit last year. Now the demand for their expertise is higher than ever, says Devin Jopp, EdD, MS, who was recently appointed as CEO of the Association for Professionals in Infection Control and Epidemiology (APIC).
Jopp has identified several crucial goals where APIC can help with current infection prevention challenges and build toward a better future for the industry. The work begins, he says, with creating a pathway into the profession—one that would make it easy for aspiring IP professionals to access education and training.
“There are several problems plaguing the industry when it comes to meeting the expanding demand for infection preventionists,” Jopp says. “They’ve been in high demand, both on the front lines of addressing COVID-19 in our healthcare settings and at the same time, they are being asked to work with other sectors; for example, hospitality and entertainment sectors.”
COVID-19 required APIC to staff up, but there were good reasons to develop a pipeline for infection prevention even before the pandemic. “The second problem we face is an aging workforce,” he says. “Many of our infection preventionists are aging out of the profession. This is not a problem that is just beginning, but one that we have reached a critical point. In essence, the shortage is here. Add in burnout, and that’s creating pressure on availability of IPs.”
The third problem in this equation is that, currently, there’s no straight line into infection prevention. “There’s no way to become an infection preventionist unless you re-career into it,” says Jopp. “That’s a real challenge. Today, you cannot take a straight career path to become an IP and cannot get a degree in infection prevention. This further limits the supply of available IPs.”
The profession is multidisciplinary, drawing upon nurses, lab techs, public health professionals, and a wide array of other career paths, so many skilled professionals could be ready to explore this specialization. Jopp notes that we must take a holistic approach and look at creating programs across the spectrum of higher education—including certificate, undergraduate, and graduate degree programs. “This is a national imperative, and this takes a tremendous amount of effort to stand up, but we have to work fast,” says Jopp.
And that goal isn’t a terrible lift, he says; it just requires getting the right partners together. A number of universities are already interested in collaborating. “Think of it as infection prevention in a box. You’ll be able to create it with these building blocks. The key learning objectives, seminal texts, and knowledge competencies need to all be defined,” he says. “We want to allow universities to be creative with their programming but need to ensure that the core knowledge of the program is consistent.”
Jopp says the APIC team has been pleasantly surprised by the number of universities raising their hands to get involved on the design side, including a Canadian institution. “When we do this, it will not only inspire what we’re doing here in the U.S., but also internationally,” he says.
As a possible bright side to the pandemic, we might see increased interest in this important profession. Building a strong network of IPs is crucial to ensure organizations both inside and outside of healthcare have the expertise to keep communities safe from infection.
“We need to unlock the infection prevention profession and help create a healthy pipeline for the next generation of IPs,” says Jopp. “I believe the demand is there and once we create this new pathway, students will flock to this profession. As an example, one institution participating in the creation of the academic pathway just launched a new certification program and was overwhelmed with student enrollments.”
Beyond education and training for future IPs, there’s also room to make a difference with education and outreach to help frontline workers in many settings, not just healthcare.
Addressing burnout
While looking to the future, it’s also important to acknowledge and assist with the burnout IPs are experiencing after a year of pandemic lockdowns. “It’s been so hard to see the terrible toll that COVID has had on patients, and recent research suggests that [there are] lingering effects and mental health impacts” that persist beyond the acute phase of the infection, says Jopp. “The impact on providers has also been significant, and we are watching the pandemic take an emotional toll on our IP community.”
APIC is working on a partnership with an Ohio State University research program to measure IP well-being and resiliency. They hope to offer some useful tools and interventions to help their members. “We, as an association, have to help them navigate through this,” he says.
Locally, Jopp urges institutions to continue to create communities of healing and recovery. But burnout was already an issue for healthcare providers, even before the pandemic. “Before I came to APIC, I served as the CEO of the American College Health Association, and we were already working to address provider burnout,” he observes. “Throw in a pandemic and the related stress and pressure, and the anxiety and depression levels build to an entire new level.”
Providers are resilient, but they may also be prone to silent struggling, wherein they may turn to outlets, both healthy and unhealthy, to cope. “We’re really seeing this manifest in organizations,” says Jopp. “Working long hours in difficult situations takes a toll on individuals.”
As CEO of the American College Health Association, Jopp was part of its COVID-19 task force in early 2020. The group spent the bulk of that year developing guidelines for the reopening of higher education. “Before COVID, inside universities, some of the worst public health threats that could happen was an active shooter or a meningitis outbreak,” says Jopp. “Through my work of addressing infections in a college setting, I built an interest in this specific area of focus and jumped at the opportunity to help lead our efforts nationally at APIC.”
Working for APIC during this historic period has been “fast and furious,” Jopp says, and an opportunity to greatly advance the profession and develop collaborations with other industries to involve IPs in new spaces.
“One interesting challenge not many saw coming was others without the requisite expertise entering the space and being asked to serve as experts in infection prevention without adequate backgrounds,” says Jopp. “That’s been a real challenge. We continue to encourage organizations to lean on their IP to help them navigate through this pandemic and frankly, to help guide them through all infection prevention and control issues.”
Infection prevention and long-term care
Jopp is also interested in seeing infection prevention develop a stronger presence in one area that keenly felt the effects of the pandemic: long-term care facilities. “One of the challenges that became quite evident through the pandemic is that infection prevention was not systemically and uniformly present in the long-term care setting in the way that it is with acute care. We saw the tragic outcome of this with COVID-19.”
Many long-term care facilities either don’t have an IP or treat infection prevention as one of many hats a person wears, leaving the discipline underprioritized. “We as a country need to invest in our [long-term care] infection prevention infrastructure,” says Jopp. “We must create a common threshold for IP expertise and practices within these organizations.” The virus spread rapidly in long-term care facilities, something APIC hopes to help prevent in the future.
“The other part of this is we need to do a better job with surveillance,” says Jopp. “We need a national process for reporting infections, like we [have] in acute care settings. We have urged legislative and regulators to require that [long-term care facilities] submit data to the National Healthcare Safety Network (NHSN). We need real-time data so that we can take timely action in the future on trends.”
Right now, Jopp notes, long-term care is paying attention to infection prevention, so there’s an opportunity to take action for lasting improvement. “We have to make sure we don’t lose vigilance on this topic,” he emphasizes. “We also need Congress and the states to ensure that there is proper funding for these added measures and staffing.”
The acute care model for healthcare-associated infections is the gold standard—the long-term care industry needs a similar model that can measure what’s happening and take action. “It’s going to take a lot of resources and follow-through,” says Jopp. “This is an enduring commitment.”
It stands to reason that there will be a new motivating factor for these improvements: After a global pandemic, families and consumers will demand a higher level of infection prevention. “Long-term care facilities are not only going to have to implement higher levels of infection prevention readiness, but they are going to also have to build robust ways to measure these efforts. Families, as consumers, are going to demand that infection prevention be at the forefront as they consider [the choice of] who will help care for their loved ones,” says Jopp.
The world has had close calls with other viruses in recent times, but it took the weight of COVID-19 to capture everyone’s attention. “We had near misses over the years, with H1N1 or Ebola, but none of those previous epidemics truly stuck with us,” says Jopp. “The tremendous death toll and impact on our society makes this different, and I want to believe that we can take this terrible tragedy and help future generations avoid this from happening.”
It’s difficult to make the necessary changes rapidly, of course. “We’re moving systems, and it’s hard to do that overnight. However, we cannot fail in our efforts. We must make the commitment and build infection prevention systems that endure and that we can count on in future emergency crisis situations,” says Jopp.
He concludes, “As a healthcare system, we have to build our capacity to be able to respond to novel pathogens in the future. We must take our lessons learned from COVID-19, remember the terrible costs of this pandemic, and make real and sustainable changes to prevent it from occurring again. Ensuring we have infection preventionist expertise is one of the critical ingredients to enhance our preparedness.”
Matt Phillion is a freelance writer covering healthcare, cybersecurity, and more. He can be reached at matthew.phillion@gmail.com.