We recently sat down with Comagine Health’s medical director for systemwide quality improvement, Dr. Sarah Woolsey, to talk about the importance of infection prevention during COVID-19.
Dr. Woolsey is a board-certified family medicine physician with over 20 years of experience caring for underserved populations.
How is COVID-19 changing the field of infection prevention?
Let’s start at the beginning. What is infection prevention? Infection prevention is an evidence-based approach designed to prevent harm to health care workers and patients. It's evidence-based, but it’s also tailored to the setting.
What do I think has changed? I think it has shined a huge light on the gaps in training and the availability of the right protective equipment, of the practicality of preventing a virus that we don't even know we have and we're already spreading it. It's requiring us up our game in all settings.
Can you briefly describe what makes for a good infection prevention program? What are some of the key factors that one needs to consider in any setting?
First, it needs to be evidence-based. There has to be training based on evidence. And with COVID-19, the science is getting updated quickly, so we need to be able to adapt to what's emerging and what’s best practice.
We also want to have what we teach be understandable in the setting. We need it to be something that's reproducible, that people can do again and again and that we can watch and measure. And if it's not going well, improve it right there with the input of the front-line team. It needs to work for them in the constraints they're dealing with.
If something is going really well, we want it to be done over and over again. We reinforce that. Sometimes it takes one-on-one training to really make it work.
At Comagine Health, our work often focuses on the most vulnerable members of our communities. Who is most at risk when outbreaks such as COVID-19 occur and how does infection prevention help fill those gaps?
I would say settings where people work or live close together. We use the word congregate settings, but it's really where there are people close together. Are they able to follow some of the basic practices like hand washing? That can be a challenge for people that may be bed-bound in a long-term care facility. Or if someone has a memory problem, they can't remember to follow a simple step that's going to keep them safe. Those groups are a big, big challenge.
The second one is any place that there's aerosol-generating procedures. COVID-19 is respiratory. It's easily spread through the air. Any place that folks are giving nebulizers or treatments that get that into the air, we need to make sure that the staff know how to use their equipment, know how to sanitize it and how to store it so they can avoid contaminating or bringing that infection to their other coworkers and other patients.
And finally, any groups that haven’t done this before. For example, an employer that's trying to figure out how to make sure everybody washes their hands or that people are six feet apart. That is a group that I'd want to focus on and really hone their skills and teach them some new things.
What are we learning from COVID-19 that will change infection prevention practices for the better?
I think it's transmissibility. COVID-19 is so easy to transmit that we have to really up our training and our use of our protective equipment. We need to make sure that everybody's doing this all the time. And I think that's going to help when winter comes and the flu comes. When we have another infection that we will battle in the future. People have really paid attention to what makes the most difference in how we do this in our various settings and how do we keep people safe. So I think it's really focusing attention that will give us future gains as we deal with whatever the next infection is.
Watch a video of the full conversation.