New guidance: Bridging the gap between what we know and what we do

Newswise — ARLINGTON, Va. (July 11, 2023) —Five medical societies have released guidelines for implementing approaches to infection control in acute care environments that consider factors such as facility conditions, team culture and communication style, hospital policies, available resources, support from leadership, and staff engagement.

"There is no optimal approach to practice implementation, but the process does not have to be excessively intricate," stated Joshua Schaffzin, MD, a senior author of "Implementing Strategies to Prevent Infections in Acute Care Settings," which is a recent addition to the Compendium. This publication consists of various alternatives and practical resources that can be utilized to discover the most effective means of successful implementation. It serves as a bridge between the Compendium on paper and its practical application at the bedside, ultimately enhancing patient safety measures."

The recently introduced section provides a concise overview of seven models designed to facilitate the implementation of additional recommendations from the Compendium for preventing prevalent healthcare-associated infections. Its purpose is to address the "knowing-doing" gap, a phenomenon that elucidates the reasons why healthcare practices frequently deviate from established evidence in infection prevention, ultimately endangering patients.

The intricate nature of healthcare systems poses challenges for healthcare teams when it comes to implementing optimal infection prevention practices. In order to identify the most suitable framework for a specific setting, it is crucial to comprehend the factors that facilitate or impede the adoption of these practices within that particular context. This understanding serves as a pivotal step towards ensuring effective deployment.

"Devoting time to actively listen and thoroughly explore your context, taking into account local factors such as operational support, informatics resources, familiarity and experience, willingness to change, and safety considerations, holds immense value and serves as a compass towards achieving success," emphasized Schaffzin. "It is important to acknowledge that people are often resistant to change. Feeling discouraged is natural, but it is crucial not to lose hope and persevere in your efforts."

Schaffzin drew a parallel between implementing new infection prevention strategies and persuading a young child to sample unfamiliar food. Just as it can be effortless at times, there are instances where one must employ various approaches to succeed. However, it is important to recognize that forcing new behaviors is not an effective approach in either situation.

"Research in the field of implementation science highlights the importance of identifying effective interventions as a crucial initial step prior to their deliberate implementation in real-world settings," stated Kavita Trivedi, M.D., Director of Clinical Guidance and Communicable Disease Controller at the Alameda County Public Health Department in California and the lead author of the chapter. "Through this publication, we offer readers the necessary resources to contemplate implementation strategies and assess the contextual factors that influence behavior. This, in turn, facilitates the design of more effective and tailored interventions, resulting in increased success rates."

The recently added section, "Implementing Strategies to Prevent Infections in Acute Care Settings," is a new addition to the Compendium, which was originally published in 2008. The Compendium is sponsored by the Society for Healthcare Epidemiology (SHEA) and represents a collaborative endeavor led by SHEA in conjunction with the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association, and The Joint Commission. Numerous organizations and societies with content expertise have made significant contributions to the Compendium, making it a comprehensive and inclusive guidance resource. This collective effort spans multiple years and involves the collaboration of over 100 experts from various parts of the world.

In the upcoming weeks, an updated version of strategies aimed at preventing catheter-associated urinary tract infections will be published. Additionally, the societies have recently revised strategies for preventing various other infections, including methicillin-resistant Staphylococcus aureus infections, Clostridioides difficile infections, surgical site infections, central line-associated bloodstream infections, ventilator-associated and non-ventilator-associated pneumonia and events. Moreover, they have also focused on strategies to prevent healthcare-associated infections through the promotion of proper hand hygiene practices.

Every article within the Compendium encompasses infection prevention strategies, performance measures, and implementation approaches. The recommendations provided in the Compendium are formulated through a comprehensive process that involves synthesizing systematic literature reviews, evaluating the available evidence, taking into account practical and implementation-related factors, and incorporating expert consensus. This ensures that the recommendations are based on a robust foundation of research, practicality, and expert knowledge.

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