Strategies for Reducing Healthcare-Associated Infections in Hospitals

Introduction

Healthcare-associated infections (HCAIs) pose a significant threat to public health, contributing to illness and death and ranking as the second leading cause of mortality. Additionally, statistics indicate that for every hundred patients admitted to a hospital, seven in high-income countries and ten in emerging and low-income nations contract at least one type of HCAI. Compounding this issue, nearly all pathogens have developed resistance to antimicrobials, while the development and introduction of new antimicrobial agents remain scarce.

What Are the Universal Precautions Followed in Hospitals to Prevent Infections?

The rise of life-threatening infections such as SARS (severe acute respiratory syndrome) and the re-emergence of diseases like plague and tuberculosis underscores the critical importance of effective infection control programs in all hospitals and healthcare environments and the necessity to enhance the skills and knowledge of healthcare workers to enable them to enforce these programs. The spread of infection can be restricted when done appropriately through efficient infection control programs.

These programs also help in reducing the mortality and morbidity of patients, cost, and length of hospital stay. In certain scenarios and depending on the patient's condition, additional infection prevention measures may be necessary. The World Health Organization (WHO) advises the following precautions for all patients:

1. Hand Hygiene: After coming in contact with blood, body fluids, or contaminated items, regardless of glove usage, it is essential to wash their hands. Also, the doctors should make sure to wash hands after removing gloves and in between interactions with different patients. For routine hand washing, plain soap suffices, but in specific situations, antimicrobials should be used.

2. Gloves: When healthcare workers tend to handle blood, body fluids, excretions, secretions, or other important items, it is mandatory to wear gloves. Before touching any damaged skin or mucous membranes, it is important to wear clean gloves.

3. Gowns: When conducting examinations, procedures, or providing patient care that is anticipated to result in splashes or sprays of blood, bodily fluids, and other secretions or excretions, it is essential to wear a gown.

4. Mask, Eye Protection, and Face Shield: For examinations, procedures, or patient care activities where there is a risk of splashes or sprays of blood, bodily fluids, and other secretions or excretions, it is crucial to wear a mask in conjunction with eye protection or a face shield.

5. Patient Care Equipment: Before using any reusable equipment with a new patient, it is imperative to ensure that the equipment has been thoroughly cleaned and properly processed.

6. Environmental Control: To maintain a safe and hygienic environment, it is essential to clean, disinfect, and maintain all environmental surfaces by establishing routines and procedures for routine care.

7. Linen: Linens contaminated with blood, body fluids, and secretions must be handled to minimize the risk of skin exposure while also preventing the transfer of contaminants to other patients and the surrounding environment.

8. Occupational Health and Bloodborne Pathogens: Exercise caution to avoid injuries when working with scalpels, needles, and other sharp instruments. Consider using ventilation devices as a substitute for mouth-to-mouth resuscitation.

9. Place of Care of the Patient: If the patient contaminates the environment or is unable to maintain proper hygiene, it is advisable to isolate them in a separate room.

What Are the Strategies for Reducing Healthcare-Associated Infections in Hospitals?

Following are the strategies implemented by public health to prevent hospital-associated infections:

• Hand Hygiene: Foster a culture of strict hand hygiene among healthcare professionals. Ensure convenient access to hand sanitizers and actively encourage frequent hand washing, particularly before and after interacting with patients.

• Infection Control Committees: Form a multidisciplinary infection control team tasked with the development, implementation, and oversight of infection control programs.

• Education and Training: Deliver continuous education and training to healthcare personnel, focusing on infection prevention practices. This should encompass appropriate hand hygiene, isolation precautions, and the sterilization of equipment.

• Isolation Precautions: Introduce suitable isolation measures for patients with infectious conditions to reduce the transmission of pathogens.

• Antibiotic Stewardship: Advocate for the careful and responsible utilization of antibiotics to prevent the emergence of antibiotic-resistant microbes and decrease the likelihood of healthcare-associated infections.

• Environmental Cleaning: Uphold a strict cleaning and disinfection schedule for the patient care species and equipment. Utilizing the correct disinfectants and cleaning protocols is important.

• Patient Placement: Segregate patients with contagious infections, adhere to appropriate room assignments, and work to mitigate the risk of cross-contamination.

• Vaccination: Promote and facilitate vaccination for eligible patients and all healthcare workers to prevent the transmission of vaccine-preventable diseases that are associated with hospital stays.

• Surveillance: Create a comprehensive system for the continuous monitoring and reporting of hospital-associated infections. Regularly scrutinize data to pinpoint trends and initiate targeted interventions aimed at prevention.

• Medical Device Safety: Guarantee the adequate sterilization and maintenance of medical devices to avert infections linked to these devices.

• Visitor and Family Education: Educate family members and visitors on infection prevention practices and furnish them with explicit guidelines concerning their involvement in patient care.

• Respiratory Hygiene and Cough Etiquette: Encourage adherence to respiratory hygiene practices and supply masks to patients displaying respiratory symptoms.

• Waste Management: Safeguard the safe handling, storage, and disposal of medical waste, encompassing harps and materials contaminated with pathogens.

• Adherence to Guidelines: Enforce the strict adherence of healthcare personnel to evidence-based infection prevention guidelines and established protocols.

• Monitoring and Feedback: Furnish healthcare workers with feedback and performance metrics to motivate them to adhere to infection control practices effectively.

• Research and Innovation: Allocate resources for research and innovation endeavors to create novel technologies and best practices that advance infection prevention within healthcare settings.

• Patient Empowerment: Promote patient engagement by encouraging individuals to take an active role in their care and also provide education about infection prevention.

• Collaboration: Cultivate collaborative relationships between public health agencies and hospitals to improve strategies for reducing hospital-associated infections.

Conclusion

All healthcare workers must implement care principles aimed at preventing healthcare-associated infections. However, it is important to acknowledge that not all infections can be entirely prevented. Certain risk factors such as the advanced age of the patient, underlying medical conditions, severity of illness, and patient’s immune status all decide the patient’s susceptibility to infection.