Overcoming the COVID-19 Pandemic: A Review of Core Practices for Infection Control

The Pulse | Thursday, April 23, 2020

J. Hudson Garrett, Jr., PhD MSN MPH MBA FNP-BC PLNC VA-BC IP-BC CFER CPPS FACDONA FAAPM FNAP

COVID-19 infection has definitely wreaked havoc on the global healthcare system over the past few months. While the virus is primarily spread thru respiratory droplets and vapors, there is published data that suggests the virus can be transmitted via other alternate routes such as fecal transmission which can be problematic in certain procedural areas. In addition, the Centers for Disease Control and Prevention (CDC) has documented widespread community transmission, which has exponentially increased the risk to both healthcare providers as well as general members of the public. Currently, those with significant existing comorbidities are at highest risks for COVID-19 infection and complications. These high-risk patients include those that are immunocompromised, have chronic respiratory conditions such as COPD, older patients and have chronic medical conditions such as diabetes, hypertension and renal disease.

The CDC has emphasized several core infection control core practices to prevent the transmission of COVID-19 which include:

Minimizing the chance for exposures by maintaining strict isolation guidelines
Frequent hand hygiene with either soap and water or alcohol-based hand sanitizer
Use of appropriate personal protective equipment and proper donning and doffing procedures (gloves, gown, facemask if a respirator is not available, and eye protection)
Use of source control (providing a mask to patients) by limiting patients as sources of transmission
Use of telemedicine capabilities to deliver clinical services when appropriate and possible
Isolating symptomatic patients immediately upon entry into the healthcare facility
Avoiding aerosol-generating procedures if at all possible
Limiting visitation to inpatient environments
Keeping the door to the patient’s room closed at all times
Reserving airborne infection isolation rooms for patients who will be undergoing aerosol generating procedures
Implementing the use of engineering controls such as partitions, separate rooms, curtains, etc.
Training and educating healthcare personnel on COVID-19 infection prevention efforts
Working collaboratively with healthcare facility infection prevention colleagues and local public health officials
Appropriately screen patients prior to making physical patient contact (may be done over the phone prior to arrival)

While COVID-19 is a novel virus and presents our healthcare communities with many challenges, it is a virus that we now better understand the primary routes of transmission for and therefore can manage transmission risk for both the patient and the healthcare provider team. It is also imperative that we implement lessons learned to prepare for future pandemics and outbreaks by hardwiring core infection prevention and control practices throughout each clinical practice environment across the healthcare continuum of care. Given the upcoming winter period which is normally full of common respiratory infections such as influenza, ongoing preparedness is critical to protecting the healthcare workforce and also the patients that we are charged with caring for. For more information on COVID-19, visit www.cdc.gov/coronavirus or www.sgna.org.

Dr. Hudson Garrett is an adjunct assistant professor in the Division of Infectious Diseases at the University of Louisville School of Medicine. He is board certified in infection control, patient safety, and also endoscope reprocessing. He is an international expert in infection prevention and control and frequent lecturer.

View Dr. Garrett's SGNA webinar in the eLearning Center: Clinical Implications of COVID-19 Infection: Strategies for Preparedness, Mitigation, and Clinical Operations.