This document identifies knowledge gaps and challenges in healthcare epidemiology research related to coronavirus disease 2019 (COVID-19), including those related to nursing homes and social disparities, described in 10 sections: epidemiology, outbreak investigation, surveillance, isolation precaution practices, personal protective equipment (PPE), environmental contamination and disinfection, drug and supply shortages, antimicrobial stewardship, healthcare personnel (HCP) occupational safety, and return to work policies. Each section highlights three healthcare epidemiology research questions.

This SHEA Research Committee document highlights four categories in which gaps exist in antibiotic stewardship (AS) research: 1) a scientifically rigorous evidence base to define optimal antibiotic prescribing practices, which adequately inform AS interventions across a variety of patient populations and settings; 2) effective AS approaches to recognize effective interventions, knowledge of how these interventions can be adapted for implementation both locally and across diverse settings, and an understanding of how interventions can be sustained once implemented; 3) standardized process and outcome metrics; and 4) advanced study designs with appropriate analytic methods, accompanied by infrastructure to support data collection and sharing.

Contemporary infection prevention and antibiotic stewardship program practices across 64 SRN facilities, compared to findings of a 2013 SRN survey published by Morgan et al. Notable findings include decreased frequency of active surveillance for methicillin-resistant S. aureus, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.

Research in healthcare epidemiology and antimicrobial stewardship is rapidly expanding with the involvement of researchers from varied countries and backgrounds. Researchers must use scientific methods that will provide the strongest evidence to advance healthcare epidemiology, but there are limited resources for information on specific aspects of healthcare epidemiology and antimicrobial stewardship research or easy ways to access examples of studies using specific methods. In response to this need, the SHEA Research Committee has developed a series of white papers on research methods. The objective of this series is to promote rigorous healthcare epidemiology research by summarizing critical components, practical considerations, and pitfalls of commonly used research methods:

  • Introduction
    Morgan DJ, Safdar N, Milstone AM, Anderson DJ. Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship. Infection Control & Hospital Epidemiology. Cambridge University Press; 2016;37(6):627–628.
  • Observational Studies
    Snyder GM, Young H, Varman M, Milstone AM, Harris AD, Munoz-Price S. Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship—Observational Studies. Infection Control & Hospital Epidemiology. Cambridge University Press; 2016;37(10):1141–1146.
  • Randomized Control Trials
    Anderson DJ, Juthani-Mehta M, Morgan DJ. Research Methods in Healthcare Epidemiology and Antimicrobial Stewardship: Randomized Controlled Trials. Infection Control & Hospital Epidemiology. Cambridge University Press; 2016;37(6):629–634.

Responsibilities in 2013 and anticipated responsibilities in 2014 for hospital epidemiology and infection prevention in SRN facilities. Findings: hospitals expected more surveillance for MDROs and device-related infections, implementation of new interventions and initiatives, including chlorhexidine bathing, monitoring of environmental cleaning, and antimicrobial stewardship; however, no additional resources to support the growing responsibilities and complexity of infection prevention programs and challenges. 

The SHEA Research Committee's recommendations for high-priority research topics, and a road map for making progress toward these goals. It updates the 2010 SHEA Research Committee document, “Charting the Course for the Future of Science in Healthcare Epidemiology: Results of a Survey of the Membership of SHEA,” which called for a national approach to healthcare-associated infections (HAIs) and a prioritized research agenda. This paper highlights recent studies that have advanced our understanding of HAIs, the establishment of the SHEA Research Network as a collaborative infrastructure to address research questions, prevention initiatives at state and national levels, changes in reporting and payment requirements, and new patterns in antimicrobial resistance.

Since its inception, SHEA has promoted research into prevention of adverse events in hospitals. In 1995, SHEA made this mission concrete by initiating a collaborative research project with the Joint Commission on the Accreditation of Health Care Organization (now known as the Joint Commission). This paper reviews the history of SHEA research collaborations.

This white paper describes the results of a survey of members of SHEA that: 1) measured members' perceptions of gaps in the healthcare epidemiology knowledge base and members' priorities for SHEA research goals, 2) assessed whether members would be willing to participate in consortia to address identified gaps in knowledge, and 3) evaluated the need for training for the next generation of investigators in the field of healthcare epidemiology.