Slowly but Surely, Infection Prevention Moves Beyond COVID-19

For the most part, infection preventionists (IPs) will be doing a lot of what they’d been doing before COVID-19 struck once society and the health care system finds its new normal. That’s the opinion of Jody Feigel, RN, MSN, the nurse manager for infection prevention at the VA Pittsburgh Healthcare System. “We’re still going to do the same surveillance. We’re going to do the same reporting. We’re going to continue with education,” says Feigel, a member of Infection Control Today®’s Editorial Advisory Board. That’s not to say that the pandemic did not change certain aspects of the IP’s job for good, adds Feigel. “I think it has helped elevate our departments, and the need for infection prevention. I hope it’s helped everyone.” It certainly fostered stronger ties between the infection prevention department and the occupation health and emergency departments, ties that Feigel believes will stay strong even as COVID-19 recedes.

Infection Control Today®: Now that COVID-19 seems to be going away, what do infection preventionists need to focus on?

Jody Feigel, RN, MSN: What we’re going to focus on now is just getting back to normal. Increasing the capacity in our boardrooms. Getting people back into meetings, instead of everything being virtual. Letting people eat together in break rooms. Decreasing the size of social distancing. You know, instead of six feet, going back to three feet. Lifting some of our masking mandates. Although [because] we’re on federal property, we’re still going to need to wear masks.

ICT®: Has the infection preventionist job changed in any way as a result of this pandemic? Will there be things added that you didn’t do before?

Feigel: I think a lot of it’s going to be the same. We’re still going to do the same surveillance. We’re going to do the same reporting. We’re going to continue with education. We’re going to be prepared for the next pandemic, because we’re pretty sure something’s around the corner. We’ve learned a lot from this pandemic. I think that we’re more prepared for what’s ahead of us. But for the most part, infection preventionists are going to go back to surveillance and education around everything we did before, just a little bit more.

ICT®: Hopefully we’ll be more prepared?

Feigel: Worldwide we were not prepared for a pandemic like this. We didn’t have the supplies in times that we needed. Our logistics department did a fabulous job of trying to get the resources

Jody Feigel, RN, MSN

we need, and really did step up throughout this entire pandemic. Cleaning products across the world were hard to come by. But somehow, we all got through it. The fears that people had to deal with, whether they were taking something home to their family, or whether they were going to get sick themselves. We really tried to alleviate those fears. Because it was completely unknown what was going to happen. I think that a couple of the things we learned were that we need to be more prepared across the board, across the world. And that education is really something that is beneficial on an ongoing, daily, hourly, continuous basis for all of us.

ICT®: Was there a way to be more prepared?

Feigel: I don’t think so. We practiced for Zika. We practiced for Ebola. We had all our measures in place. We just didn’t note the extent of how COVID was going to impact any of us. We certainly didn’t think that—or even realize that—so many people across the world were going to die.

ICT®: Do you think more health care professionals will want to be infection preventionists?

Feigel: Infection prevention is definitely a niche position. You either love it or you don’t. We look at it as an opportunity to solve a puzzle or solve a mystery, because we need to find out if the patient or the guest came in with the infection. And if they did, then it’s community acquired. Or is there some process or something in our processes that we can improve to keep our patients safe from developing infections. So, we follow our bundles. We are reading all the time, looking at the literature to see how we can improve that care. But a lot of times it’s patients are sick. And it’s unfortunate that people still do get hospital-associated infections.

ICT®: Are you personally hiring more infection preventionists?

Feigel: My department is pretty robust. I don’t know that I’ll be hiring right now. I’m at my max. But I think worldwide there is going to be a greater need for infection prevention.

ICT®: What do you love about infection prevention?

Feigel: For me, it’s a different way of nursing and a different way of contributing to health care. And that’s why I went into nursing 34 years ago. It’s just different. And I like the puzzle-solving piece of it. I like the education piece of it. And I like it that every day I’m learning something new, even though I’ve been doing this for 15 years. Every day there is an opportunity to help someone and to learn something. My department is always out and about. COVID-19 has elevated the importance of infection prevention, for sure. And I think that’s helped across every hospital or every health care facility in the world. Because people were coming to us for answers where a few years ago, nobody wanted to hear from infection prevention. Now, everybody wants to hear from infection prevention, which is a good thing. We’re not knocking on people’s doors anymore, asking them to pay attention to us or to listen to us. I think it has helped elevate our departments, and the need for infection prevention. I hope it’s helped everyone.

ICT®: When you say that before nobody wanted to hear from you. Was that the whole hall monitor rap that infection preventionists would get sometimes?

Feigel: We were hall monitors. We have a lot of nicknames that people have given us. Some of them not so nice, but it’s OK. You know, we’re keeping people safe. And that’s really what infection prevention is all about. Safety. It’s for patients, for our employees, for vendors that come in the facility. We need to keep everybody safe that enters.

ICT®: There’s more interest in what you do.

Feigel: I don’t have people knocking on my door. There’s no line, but I think people are definitely more interested in what we bring to the table, for sure.

ICT®: And what do you bring to the table? When somebody does express an interest in becoming an infection preventionist, what do you say? What skills or interests will that person need?

Feigel: They need to be interested in patient safety. They need to be interested in microbiology. They need to be interested in stopping hospital-associated infections. Education is huge with us. Any of those combinations help. Getting people from microbiology is always a gift, because they do have that wonderful background. Where in nursing, sometimes nurses aren’t real strong in their micro. Getting people from ICU is incredibly helpful as well. Whether he or she comes from micro, the floor in ICU, the emergency department, even if they have previous infection prevention experience, depending on what kind of facility they came from [would make for a good background].

ICT®: Did COVID-19 bring infection prevention and environmental services closer together?

Feigel: Environmental services is always incredibly important to infection prevention. As is facilities management or the maintenance department. We all have to work as a team to make sure that our buildings are safe, that our buildings are clean, and that we’re doing the right thing for our patients. So that dynamic has not changed. The bond is probably strengthened because we are working a lot more closely. But you know, I talk to our FMS and EMS guys multiple times a day just to make sure that we’re all on the same page.

ICT®: Are you worried about the flu season this year?

Feigel: No. After last year, I think in our entire county, we only had 80 cases, if it was even that. We saw no flu at VA Pittsburgh. But people wearing masks, people had a heightened sense of hand hygiene. If people continue to get vaccinated like they did last year, I think we’ll be fine. We had really nothing to worry about except for COVID this past winter. So hopefully people will be comfortable wearing a mask again. I am certainly not shedding my mask anytime soon, even though I’m vaccinated. I think it’s important. I think it’s going to be an interesting flu season for sure. And I’m hoping that people will continue to get vaccinated for influenza. If we do get COVID boosters, I think that’s important as well. So, you know, masking, vaccine, hand hygiene—all play an important part of protecting each other.

ICT®: The flu season was historically small. Do you think that the Centers for Disease Control and Prevention was able to gather enough data to take on the coming flu season?

Feigel: With flu season coming up, they’ve worked on those vaccines from Asia and eastern countries for months and months and months. They are always ahead of us. Their flu season—depending on what they’ve had is what we may see. With them wearing masks and continuing the same safety guidelines that we’re all doing, I don’t know that it’s going to be any different. Hopefully people still follow the same guidelines. We’ll just have to play it by ear and see how it goes. Honestly, I wish I had a crystal ball that could predict that.

ICT®: What other departments did you get to see more of because of the COVID-19 pandemic?

Feigel: The emergency department and occupational health has just been incredibly instrumental during this pandemic because they actually took care of the employee side of our COVID positives. Where infection preventionists took care of the outpatients and inpatients. We work very, very closely. Probably the closest we’ve worked with oc-health in forever.

ICT®: Has COVID-19 better prepared the health care system for another pandemic?

Feigel: Well, depending on what the pandemic is … if it’s another respiratory virus, we know what we need up front. We know we need masks. We know we need gowns and gloves and cleaning supplies. We know that we may need our negative pressure rooms boosted again. I think we’re in a better place because of what we have learned because of what we just went through.

ICT®: Is there anything you’d like to add about what infection preventionists should do to get ready to go back to normal that you think is important for them to know?

Feigel: No. I think everybody’s figuring it out. I think in each facility, we know that it’s going to be baby steps going back. We’re not jumping all in because we do still need to keep people safe. But we’re all going to look at social distancing. We’re all going to look at masking guidelines for our facilities. We’re going to continue to talk about hand hygiene and vaccination. I think we’re all just going to move forward slowly but surely. I’m hopeful

This interview has been edited for clarity and length.