A serious infectious threat response initiative (SITRI) at the US Veterans Affairs (VA) North Texas Health Care System (VANTHCS) was associated with reduced staff burnout during COVID-19 without increased healthcare-associated infections (HAIs), according to a study yesterday in the American Journal of Infection Control.
The VA's infection prevention and control (IPC) team implemented the SITRI after an Ebola epidemic led the Veterans Health Administration in 2015 to require preparation for emerging pathogens. Staff developed an algorithm to facilitate communications and safe care of infected patients.
After SARS-CoV-2 emerged in early 2020, the IPC team identified issues such as staff anxiety, lack of COVID-19 knowledge, and shortages of personal protective equipment and tests. Staff adapted the SITRI to better support workers, facilitate daily operations, and maintain infection-prevention protocols.
The SITRI became a 24/7 call service staffed by infection preventionists and a hospital epidemiologist who was also an infectious disease physician. The preventionists also conducted COVID-19 surveillance, data abstraction, exposure management, and public health reporting.
Weekly SITRI calls, COVID cases linked
The SITRI received 3,816 staff calls from January 2020 to March 2021. The number of weekly calls and the average census of COVID-19 hospitalizations were correlated.
Staff reported a lower burden of exhaustion in 2020 and 2021 than in 2019, but compassion fatigue rose gradually from 2019 to 2021.
Rates of central line–associated bloodstream infections, catheter-associated urinary tract infections, methicillin-resistant Staphylococcus aureus, and Clostridioides difficile infections declined or stayed the same, which the authors said could be because SITRI allowed the IPC to maintain surveillance, audits, and feedback.
During the early months of the COVID-19 pandemic, healthcare facilities lacked essential infection prevention resources and information, and staff anxiety was incredibly high.
The SITRI cost $360,000 from March 2020 to May 2021 based on IPC overtime pay for covering the SITRI line.
"During the early months of the COVID-19 pandemic, healthcare facilities lacked essential infection prevention resources and information, and staff anxiety was incredibly high," lead author Madhuri Sopirala, MD, MPH, said in an Association for Professionals in Infection Control news release. "Our evaluation shows that the VANTHCS' SITRI provided support and services that contributed meaningfully to patient safety and staff well-being during this time."