Implementing, and adhering to, good infection control practices is critical to minimizing the impact of infectious diseases, including, but not limited to COVID-19. As a consultant pharmacist, I see additional opportunities for infection control practices that may not be as obvious as handwashing or PPE.
At this point, a great deal has been written about the current COVID-19 pandemic and yet…so much remains unknown. The main discussion around COVID-19, as is the case with other infectious diseases, is how to handle infection control. As an ounce of prevention is always worth more than a pound of cure, it stands to reason that processes to avoid infection should get more attention than the potential cures. Some tactics, such as physical distancing and good handwashing techniques, are obvious infection prevention techniques — but others are not so apparent.
In this post, we’ll discuss three items that may not be immediately evident, but which are still critically important for ensuring the safety of your patients:
Policy and procedure: Having policies and procedures related to infection control in place is a clear expectation of the certification and accreditation bodies such as the Centers for Medicare and Medicaid Services (CMS), Accreditation Association for Ambulatory Health Care (AAAHC), The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) and The Joint Commission (TJC).
What isn’t obvious?
Policy development is only the first step in this process. Once the policy is developed, ensuring that adherence and compliance actually occur is another critical step that facilities find challenging. To tackle this challenge, I recommend routine education, assessments, and audits to determine compliance with facility policy.
Another item to consider? We often discuss multi-dose and single-dose vials as well as syringes and the “one-hour rule” when discussing compliance. Why is that? These are infection control issues.
If your healthcare facility’s current policies and procedures need updating — or you aren’t sure how to write and audit these policies — consider working with an expert consultant pharmacist. If you don’t have one, I can help.
Drug shortages: I have written before about how to deal with drug shortages and even how drug shortages will be different during the current pandemic. Though COVID-19 certainly has led to new shortages, the truth is that drug shortages have been with us for a long time and likely will be going forward. How do drug shortages impact infection control? Drug shortages require us to get creative and think outside the box. Coming up with innovative ways to solve common problems can be a good thing, but — it can also unmask hidden dangers. This could involve using multi-dose vials in place of single-dose vials, or using compounded versions as a more convenient alternative. Although these are viable solutions, they bring additional patient risks that must be considered. If you consider using compounded medications, it is imperative that your consultant pharmacist be involved in the process to ensure a complete vetting process is followed. This includes verifying state licensing, registration with the FDA as a 503B pharmacy and reviewing findings of inspection results. Failing to do your due diligence increases risks to patient safety and facility liability.
Antibiotic stewardship: As we all know, antibiotic stewardship is a critical component of a good infection control program. Unfortunately, many antibiotics are on the list of the drugs most impacted by current drug shortages. Shortages often lead to formulary changes in order to meet the needs of our patients. Formulary changes are a part of an evolving practice and fairly common but what isn’t obvious, however, is the process required for a formal change such as:
- Has the physician making the request gathered the evidence necessary to support the change?
- Has the medical director been involved in the process?
- Has the governing body heard the evidence and signed off on the change?
- Has staff been educated on the changes, including the specifics on the new drug?
To ensure compliance and enhance patient safety, all of the above questions should be answered with a “yes” to ensure compliance and enhance patient safety.
There are many processes that are either new, or which have been modified, as a result of the current pandemic. From time to time, a public health crisis causes us to react in the interest of minimizing the impact on our patients. An important aspect of making changes is reviewing for the possibility of unintended consequences. Don’t hesitate to lean on the experts to ensure your facility is fully compliant. Whether it’ s COVID-19, or some other crisis, feel free to reach out and in my role as a consultant pharmacist, I will help you develop a plan that enhances patient safety and increases your odds of a successful survey: click here to request a free consultation.
The Consultant Pharmacists at OctariusRx provide guidance on safe medication management, survey readiness and cost savings to ambulatory healthcare facilities/surgery centers, senior care facilities and pharmacies We also help individual patients optimize their medications to improve their quality of life and save money. Contact us for assistance.