Tackling Health Care-Associated Infections: SHEA’s Bold 10-Year Research Plan to Save Lives

Sterile Processing

(Adobe Stock 938500017 by PondLord)

Health care-associated infections (HAIs) remain a serious challenge, impacting 3% of hospitalized patients and costing billions annually. To combat this, the Society for Healthcare Epidemiology of America (SHEA) has unveiled an ambitious 10-year research agenda focused on reducing HAIs and improving patient outcomes. By prioritizing implementation science, understanding transmission modes, and enhancing diagnostic stewardship, this plan paves the way for groundbreaking advancements in infection prevention.

To explore this critical roadmap for revolutionizing healthcare safety, Infection Control Today^® (ICT^®) interviewed Lona Mody, MD, the Hickey Professor of Internal Medicine, and the interim division chief of geriatric and palliative medicine at the University of Michigan and VA Ann Arbor Healthcare System; and Jennie H. Kwon, DO, MSCI, associate professor of medicine, section director of hospital epidemiology & antimicrobial stewardship at Washington University in St. Louis, Missouri.

ICT: How does the Society for Healthcare Epidemiology of America (SHEA) aim to address the financial and patient safety impact of HAIs through this research agenda?

Lona Mody, MD: Research agendas highlight areas for future investigation, address knowledge gaps, and determine the next big thing to address our toughest challenges. As a junior investigator, my prior research agendas have shaped my projects and the populations I should focus on. We hope these research agendas can drive funding priorities by federal and non-federal grant-making authorities.

This research agenda addresses contemporary health care epidemiology issues that are in tune with how health care is provided today. For example, we are increasingly moving away from acute care hospitals to care at home and other post-acute settings. How can we be proactive and ensure that HAIs do not follow health care in these settings?

We highlight the role of genomic methods in informing routes of transmission and call for studies that can use this information in real time to reduce pathogen transmission infections and develop local strategies to prevent them.

As our patients often go out of their rooms for common and specialized therapies, how frequently do they transmit pathogens in commonly used areas and environmental surfaces? What should be their cleaning protocols?These are just some of the questions we hope our SHEA society members tackle.

ICT: Can you explain the role of implementation science in infection prevention and what challenges researchers face in applying these strategies in real-world health care settings?

Jennie H. Kwon, DO, MSCI: Evidence-based research can take up to 17 years to become integrated into health care practice, a barrier to improving health care epidemiology. Implementation science can enhance health care delivery by elucidating the factors and behaviors at individual and organizational levels that influence infection prevention practices across various health care settings. Implementation researchers often employ mixed quantitative-qualitative designs and help promote the systemic update of evidence-based research that is scalable.

ICT: What are some recent findings on the modes of transmission for infections in health care facilities, and how might they influence new prevention measures?

LM: Important gains have been made in defining the role of environmental contamination in MDRO epidemiology and transmission. Studies show that a multi-pronged approach that includes reducing patients’ shedding of microbes, environmental cleaning, hand hygiene, and health care provider education can reduce environmental contamination.

ICT: How does diagnostic stewardship improve patient outcomes, and how can it help reduce unnecessary treatments in infection control?

JHK: Diagnostic stewardship refers to optimizing laboratory testing to improve patient care and management. These interventions can exist across the continuum of testing, from test ordering to specimen collection, test processing and reporting, and the interpretation of results. Further research to enhance and support diagnostic stewardship interventions can help improve patient outcomes and provide high-value care. Diagnostic stewardship may also be leveraged to de-implement strategies that do not improve patient care, and that can potentially increase health care inequities. Furthermore, developing performance metrics to measure the impact of these interventions can provide meaningful feedback to facilities.

ICT: How do you see this 10-year research agenda by SHEA influencing future health care practices or policies related to infection prevention and patient safety?

JHK: This research agenda is a critical first step in addressing our profession's current knowledge gaps and research needs. This effort aims to bring to light the challenges facing infection and hospital epidemiology and set out the priorities for research now. As we disseminate this work to researchers, administrators, the public, and funders, this will set the stage for innovation in health care epidemiology and infection prevention research. Ultimately, this will make health care better for all.

LM: Clearly, we need to learn more and test more interventions. Importantly, as Jennie mentions, how can we implement tested inventions quickly and effectively while maintaining patients’ dignity and independence?

We feel that answers to these questions have huge potential to enhance infection prevention programs and develop more champions to take this work forward.

The time is right to tackle multiple issues, including engaging underrepresented minorities in research, going beyond health care to engage other communities, such as community health organizations, schools, colleges, and businesses, and thinking globally.