1. McGoldrick, Mary MS, RN, CRNI, FAAN

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We probably all remember where we were on March 11, 2020, when the World Health Organization (WHO) declared the novel coronavirus (COVID-19) outbreak a global pandemic (WHO, 2020). I was on my last day of a mock Joint Commission survey at a home health agency. As I flew back that evening, I knew things would not be the same for quite a while but never thought it would continue for over 2 years, with no end in sight! March 11, 2020, was the day we had been preparing for with emergency preparedness planning activities. We quickly realized how ill-prepared we were for a pandemic. As the number of cases and deaths skyrocketed in the New York City area, the number of frantic phone calls and emails I received from clinicians throughout the United States escalated-questions about how to deal with the shortages of hand sanitizer, disinfectants, and personal protective equipment (PPE)...and how to protect staff and allay their (valid) fears of contracting this novel viral respiratory infection.


This response reminded me of the early 1980s when I was a home infusion nurse in the Chicago area at the beginning of the AIDS epidemic. I would make home visits and see AIDS patients (as we called them then) requiring home infusion therapy. When people learned that I cared for AIDS patients, some would take a step back out of fear of being too close to me. Our home infusion drivers wore full PPE to make a home medication delivery out of fear of contracting the disease and often nurses would refuse to see AIDS patients. At the beginning of the COVID-19 pandemic, the fear felt very similar, although with COVID-19 we have data on the number of healthcare workers who died from contracting COVID-19 (Centers for Disease Control and Prevention [CDC], 2022).


As the pandemic continued, my role expanded, and I provided public education to over 42,000 home health and hospice clinicians (that I'm aware of) on preventing the transmission of SARS-CoV-2. Updates to the Home Care Infection Prevention and Control Program manual that I author never seemed to end...just as one update was finished, the CDC would update the guidance for protecting patients and clinicians, and the content would need to be rewritten...again! Thankfully, for now, we're in a more stable phase of the pandemic with PPE, hand hygiene, and disinfectants being plentiful, and vaccines and treatment available for COVID-19.


From my perspective, the best thing about the COVID-19 pandemic was the renewed focus and attention on infection prevention and control. I've been working in infection prevention and control since the early 90s and coauthored the first and second editions of the Infection Control in Home Care and Hospice books for the Association for Professionals in Infection Control and Epidemiology and recently was inducted into the American Academy of Nursing for my work in his field. Home care clinicians have always received education and training and had their competence assessed on infection prevention and control-related topics, but COVID-19 brought a stronger emphasis on demonstrating the donning and doffing of PPE. This renewed focus that infection prevention and control received not only protects our clinicians but potentially prevents home care-onset healthcare-associated infections in the patients we serve. My sincere thanks to all the clinicians who made home visits, especially at the beginning of the pandemic, and cared for patients in the home with COVID-19.




Centers for Disease Control and Prevention. (2022, April 9). Cases and deaths among healthcare personnel.[Context Link]


World Health Organization. (2020, March 11). WHO Director-General's opening remarks at the media briefing on COVID-19 - March 11 2020.[Context Link]