Strategies to Prevent Healthcare-Associated Infections
Date: 10/22/2024
LOB: Medicaid
Audience: Meridian Medicaid Providers
From "Strategies to Prevent Healthcare-Associated Infections: A Narrative Overview," by Dr. Mainul Haque et. al. Published in Risk Management and Healthcare Policy, September 28, 2020.
Strategies to Prevent Healthcare-Associated Infections
HCAIs (their prevention and control) are a significant global public health burden about which concerns have been raised from all healthcare stakeholders, including health professionals, patients, and the public. Their impact has dramatically increased because of the advent of multidrug-resistant pathogenic microorganisms. Currently, almost all available antimicrobials are resistant and very few antimicrobials are in the process of being developed for widespread use. Amongst these pathogens, Klebsiella pneumoniae, which is the most common resistant pathogen, especially in ICU settings, is a significant concern. The prevention and control of HCAIs is therefore very complicated, and a multi-dimensional approach and strategies are required to address this significant public health concern.
The primary ways of addressing the impact of HCAIs
- Hand hygiene (HH)
- HH has been identified as the most important single behavior change that healthcare workers can make for infection control, especially in relation to HCAIs.
- Maintaining a safe, clean, hygienic hospital environment
- Infected and polluted hospital surfaces act as a key reservoir and source of transmission of life-threatening microorganisms, which include Clostridium difficile, antibiotic-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA), and vancomycin-resistant enterococci (VRE). Hospital surfaces, including both porous surfaces, eg, beds, mattresses and linen, and nonporous surfaces, eg, bed rails, door handles, call bells, and light switches are incredibly prone to microbial contamination with high-risk microbes. Maintaining strict hygiene throughout hospitals is, therefore, essential in reducing HCAIs.
- Screening and categorizing patients into cohorts
- It has been suggested that active surveillance cultures (ASCs) of all or certain high-risk patients and placing them under contact precautions will help to curb or eliminate the multidrug-resistant organisms (MDROs) that can trigger HCAIs.
- Public health surveillance
- Isolation of MDRs infected patients is one of the top priority issues in preventing or controlling an HCAIs epidemic.140,181,182 The timely recognition of the unique variants of HCAIs, especially of MDRs pathogenic microorganisms, is vital, although surveillance strategies are frequently restricted because of financial and practical limitations.
- Antibiotic stewardship
- a set of coordinated strategies to improve the use of antimicrobial medications with the goal of enhancing patient health outcomes, reducing resistance to antibiotics, and decreasing unnecessary costs.
- Following patient safety guidelines
- the control and prevention of HCAIs is best achieved through a broad, integrated approach and cooperation between healthcare facilities, public health authorities, health insurances, quality management, and patient safety organizations, educational facilities, the public, and the veterinarian sector.