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The Athletic Training Facility Shifts Focus Toward Infection Control

Since its onset, the coronavirus (COVID-19) has adversely impacted the health of every population. As COVID-19 moved to the forefront in early 2020, the effect it would have on the athletic training profession came to light.

Two members of the Department of Orthopedic Surgery – Sports Medicine Brigham and Women’s Hospital in Boston, MA – Jim Zachazewski, ATC, PT, DPT, and Michael Belanger, ATC, PT, clinical supervisor of athletic training – walked out of a meeting with other Athletic Trainers (ATs) and clinical hospital staff in late February 2020 realizing that control of infectious disease needed to be addressed head-on within the athletic training setting and they set out to tackle the challenge.

Close contact within the shared space of any athletic training facility poses a high risk of COVID-19 infection spread on many levels. Though not infection control experts themselves, Belanger and Zachazewski knew ATs nationwide needed defined policies, programs, education and transition to handle pandemic preparedness in interscholastic and intercollegiate settings. They saw an immediate need as well as a long-term goal that would positively impact the care ATs ultimately provide. It was clear to them that controlling infections had to be a shared responsibility of all – the ATs, the full sports medicine team, all athletes and school administration.

Belanger and Zachazewski searched for supplemental resources through the National Athletic Trainers’ Association (NATA) and other allied organizations. They discovered that documents related to influenza-type/respiratory illness infection control did not exist for ATs – only ones focused on skin-related infections. So, using the Brigham and Women’s Hospital infection control policy document from their employer as a starting point, they added wording related to the athletic training setting as well as justifications for changes needed.

Issues addressed included:

  • Hand hygiene and common materials – curtail infection spread through procedures and availability of common materials outside of the training room to minimize traffic
  • Athletic training facility physical space and equipment cleaning – maintain proper cleaning of hard surfaces, medical kits and equipment, including minimizing storage of supplies and gear within the training area
  • Personal Protective Equipment (PPE) – maintain availability of necessary PPE for ATs, as well as proper disposal procedures

Belanger and Zachazewski determined how the rewritten policies and procedures should be adapted to the athletic training environment. They saw that a professional, cultural and institutional transition needed to occur in the traditional athletic training setting in order to protect patients from infection.

“COVID-19 has shown a light on what this (athletic training) facility should look like going forward,” said Zachazewski. “The pandemic demonstrated what we needed to do as a profession in both education and practice. As health care professionals ATs are being pushed to step up our game and really look at how we practice in what is really an ambulatory health care setting. This is a springboard for ATs to demonstrate how we practice at a high level as health care professionals.”

Once the infection control policies were written and procedures mapped out, the next step was to share their document with the athletic training community. It was posted on NATA’s DEN forum at After posting on April 27, 2020, the response was overwhelming indicating this was a much-needed resource.

“We saw that there was definitely a need for this during the pandemic,” said Belanger. “This is not a time to protect this information. It’s a time to share our resources – helping health care professionals and student-athletes.”

In addition to sharing the document, it was promoted through educational platforms, including a webinar “Infection Control Considerations in Interscholastic and Intercollegiate Health Care Sites Post COVID-19” held at the 2020 VNATA conference on Aug. 6, 2020.

The BOC’s existing “BOC Facility Principles” document and online tool which helps athletic training facilities ensure safe, effective operation and compliance, was updated to include practices from Zachazewski and Belanger’s document, as well as Centers for Disease Control Prevention (CDC) recommended practices. Additionally, the “BOC Guiding Principles for AT Policy and Procedures” document and online tool, which guides the development of policies and procedures, was updated adding the new infection control sample policy.

After working with Zachazewski and Belanger in their initial research phase, Murphy Grant MS, ATC, CES, PES, senior associate athletic director/health care administrator with Wake Forest University Athletics in Winston-Salem, North Carolina put together a proposal for the NATA regarding pandemic preparedness.

A two-part survey was implemented to gauge employee/AT feelings regarding workplace safety and preparedness.

To foster ongoing policy progress, NATA assembled a workgroup focused on infectious disease control preparedness. Grant was named as chair, supported by Zachazewski and Belanger and several other notable experts within the athletic training and health care communities.

“I am working with an impressive group of individuals dealing with this topic,” said Grant. “We have members with boots on the ground, some doing patient care, and all have a strong understanding of infection control. We’re all looking at how we can protect employees in these spaces and keep student-athletes safe.”

The NATA workgroup is focusing on four areas:

  1. Facility Standards
  2. Equipment Cleaning
  3. Prevention/Minimizing Spread
  4. Patient/Athlete Care

According to Grant, the goal of the NATA workgroup is to develop tangible resources for ATs, furthering

the work started by Zachazewski and Belanger, and supported by athletic training and health care experts. A long-term goal to integrate formal education for ATs around infection control is being addressed, as well.

“We’re focused on putting together written documents that are easily read and shared amongst all levels of sport to meet immediate needs and grow to meet future use,” said Grant. “We are working to develop infection control policy resources and education for everyone in our industry long-term.”

The article was originally published in the 2020 winter “Cert Update” newsletter.

Jim Zachazewski
Michael Belanger
Murphy Grant
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