Best practices in reducing hospital-acquired infections

Within the U.S., the Centers for Disease Control (CDC) as well as a variety of organizations, have put forth guidelines designed to limit HAIs. Many of the interventions proposed in these guidelines are quite simple but high levels of compliance remain elusive and difficult to achieve.

Compliance among healthcare workers starts at the top, as healthcare leaders must strive to educate, motivate, and eliminate barriers to the routine adoption of these practices in everyday practice in order to prevent HAIs. A strong commitment to multidimensional best practices can undoubtedly make a significant difference in reducing the rate of hospital-acquired infections.

One of the most fundamental, and important, HAI prevention measures is the practice of proper hand hygiene. As infections are most often transmitted through the contaminated hands of healthcare workers, hospitals must ensure that their staff is fully educated on the importance of hand hygiene compliance and that barriers to achieving hand hygiene are adequately eliminated.

Decades of data have demonstrated that education without the elimination of barriers to this seemingly simple solution rarely achieves sustainable compliance. The introduction of new sanitizing hand products that can be dispensed easily at a variety of locations has significantly enhanced compliance. CDC guidelines recommend washing hands or sanitizing them with an alcohol-based rub both before and after contact with each patient.

Additionally, the use of gloves during patient care can also help to reduce transmission of infectious agents to patients. Hospital personnel should remember that gloves should always be changed when moving from a contaminated site to a clean site on the same patient, and should never serve as a substitute for proper hand hygiene.

When placing transcutaneous, indwelling devices such as chest tubes and central lines, hospitals should ensure that healthcare workers are able to utilize full barrier sterile precautions as recommended by the CDC. These precautions include wearing a cap, mask, sterile gown, sterile gloves, and a large area drape that extends well beyond the working field. Additionally, chlorhexidine prep has been shown to be more efficacious than Betadine prep.

Chlorhexidine discs for dressing of central lines have also been demonstrated to reduce infections and to be cost effective. For such measures to be effective, a high degree of compliance is required. Achieving such compliance is greatly facilitated by monitoring systems designed to improve compliance, allow tracking, and enable the provision of feedback to the unit and individual healthcare worker.

In an attempt to reduce one of the more common hospital-acquired infections, central line-associated blood stream infections, hospitals should also consider the use of antimicrobial and antibioticdefine-coated catheters in high risk patients. The antimicrobial agents contained within the catheterdefine material help to protect patients from those bacterial organisms that initially cause the infection. Of course, antimicrobial and antibiotic-impregnated medical devices should be used in conjunction with best placement practices to achieve the most effective outcome.

Hospital-acquired infection prevention is a personal responsibility of all members of the hospital staff. With a solid commitment and adherence to infection control best practices, hospitals worldwide will undoubtedly experience a significant reduction in the occurrence of fatal HAIs affecting their patients.

Thomas Cherry is the Clinical Product Manager of the Critical Care Division of Cook Medical. Thomas is a Registered Nurse and holds a Bachelors of Science in Nursing from Southeastern Louisiana University, along with certifications in critical care nursing, while also being an active member in professional societies such as APIC (Association for Professionals in Infection Control), SHEA (Society of Healthcare Epidemiology of America), and SCCM (Society of Critical Care Medicine).