Safety lessons learned during the pandemic
As much of society is realizing that life might never go back to what it was before the COVID-19 pandemic, UCLA Health physicians and other health professionals are looking at retaining some of the lessons learned during the pandemic for better preparedness in the future.
Shaunte Walton, MS, CIC, system director for Clinical Epidemiology & Infection Prevention at UCLA Health, compiled a list of practices that will help guard against future outbreaks.
Walton also identified exceptions – pandemic practices that she and some of her colleagues believe should not be continued going forward.
"Some of the things we do in a medical setting are things we've been doing for decades, but they were just more in the spotlight due to the COVID pandemic," she said. "We've also had some novel innovations in certain protections and methods, and we want to keep those going forward."
The two exceptions involve the use of protective plexiglass shields and severe restrictions on visitations to hospitalized patients.
Walton said plexiglass shields might seem like a good way to protect someone from large droplets from an infected individual. This might be true for high traffic areas such as check-out lanes at a store, but in places such as classrooms and restaurants, plexiglass walls or cubicles can interfere with the normal ventilation of a room, creating dead zones where airborne viral particles can build up, Walton said.
"Yes, we see those plexiglass dividers everywhere, and people are like, 'Oh, yeah, this is amazing. This will keep us safe,” Walton said. "But now we are realizing that, by restricting air circulation, plastic barriers will actually make things worse."
Though restricting patient visitation might be a good idea in some cases to slow the spread of a virus, it also can have significant consequences to the patient. Visitors, especially loved ones, often assist the patient and the busy medical staff by helping the patient to get out of bed and go for a walk, or just to go to the bathroom.
Walton shared information on a recent study of the impact of visitation restrictions during the pandemic. The study pointed out the importance of family members or other partners in the care process.
According to the study, during the pandemic, when organizations restricted visitation, especially those that went to no visitation at all, they saw a remarkable increase in falls, sepsis and pressure ulcers, Walton said.
“If you have someone that is in the hospital, your visitors really are serving as that advocate for you, and so they're there with you — if a person has trouble in general walking and they need to go to the restroom, you have someone there that's going to help escort you," Walton said. "That’s fall prevention at its best.”
She said family members may often be the first ones to notice a change patient in the patient’s status.
“It provides an early intervention that could have a good outcome for that patient, especially if they were developing sepsis (a potentially life-threatening bodily reaction to an infection),” Walton said.
Practices that should remain standard
On the other side of the ledger, Walton has a list of practices that she says should continue after the pandemic eventually ends.
Hand hygiene monitoring. This "has always been a front-line defense against microorganisms,” Walton said. Washing or using approved hand sanitizer works best.
Surface cleaning and disinfection. While not the primary risk for the spread of COVID-19, cleaning surfaces such as tables and counter tops is important in slowing the spread of most microorganisms.
Personal Protective Equipment (PPE), especially masks and eye protection in high-risk situations. "It is important to consider the risk when determining personal protective use,” Walton said. “If you are in a situation where you are shoulder to shoulder with people, especially not knowing their vaccination status, masks are a very good idea. Eye protection can be an additional measure in high-risk situations since the eyes are a portal of entry.”
Passive symptom screening. This is appropriate for any workplace, especially in health care. It is as simple as having employees or patrons monitor their symptoms and stay home if symptomatic.
Contact tracing via smartphone app. This enables infection prevention professionals to determine more quickly who has contracted the virus and their close contacts in order to prevent further spread.
Indoor air-quality monitoring. Proper air circulation helps prevent airborne viruses from collecting in a confined area.
COVID-19 testing. “It's no surprise that we'll want to keep COVID‑19 testing for the foreseeable future,” Walton said. “That's the only way that we're going to be able to curb the COVID-19 pandemic.”
Keep up to date on the latest information about the COVID-19 virus and vaccine at the UCLA Health COVID-19 Vaccine Information Hub.
Tina Daunt is the author of this article.