Healthcare-associated infections (HAIs) are a threat to patient safety across the continuum of care. Several types of strategies have been shown to reduce the risk of transmission of infections within healthcare settings. The Healthcare Infection Control Practices Advisory Committee (HICPAC) issues recommendations for preventing and controlling HAIs and has set guidelines on several of the prevention strategies mentioned below.
Common HAI prevention strategies are grouped into the following categories:
Standard and transmission-based precautions – Implementing standard precautions is the primary strategy for preventing healthcare-associated transmission of infectious agents among patients and healthcare personnel. These are basic steps that should be applied to the care of all patients in all healthcare settings all of the time. Transmission-based precautions, other control measures used in addition to standard precautions, are applied to the care of patients who are known or suspected to be infected or colonized with certain infectious agents that require supplemental steps to effectively prevent transmission.
Hand hygiene (HH) – Using soap and water or an alcohol-based hand rub (ABHR) to remove bacteria and viruses from hands so they cannot be transmitted to other people or environmental surfaces. Hand hygiene is a part of standard precautions.
Injection safety and bloodborne pathogen prevention (BBP) – Observing safe injection practices, monitoring blood glucose appropriately, and following the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard help prevent the transmission of bloodborne pathogens such as HIV, hepatitis B, and hepatitis C in healthcare and residential settings.
Vaccination – Receiving an immunization to help prevent contracting a disease. Many diseases (but not all) are vaccine-preventable. Some vaccinations offer long-term immunity to the individual and only need to be taken once, while some need to be given more often such as the influenza vaccine, which should be given yearly.
Environmental cleaning – Using appropriate and evidence-based methods to clean, disinfect, and sterilize patient-care medical equipment and devices as well as clean and disinfect the healthcare environment to prevent the spread of disease.
Antibiotic stewardship – Using antibiotics wisely to prevent bacteria from developing resistance to the drugs that are used to treat them.
Infection prevention strategies are geared toward breaking the “chain of infection” or “chain of transmission” . In order for an infection to occur, each link of the chain must be connected. Breaking any link of the chain can stop the transmission of infection.
The six links of the chain of infection are:
- Infectious disease (any microorganism such as a bacterium or virus that can cause disease)
- Reservoir (place where an infectious disease lives, thrives, and reproduces)
- Portal of exit (place where the organism leaves the reservoir)
- Mode of transmission (how an infectious disease transfers from one person or object to another person)
- Portal of entry (place where the infectious disease enters the body of a susceptible host)
- Susceptible host (a person at risk for developing an infection)
In healthcare facilities, it is also important to create a culture of safety and to encourage effective communicationbetween healthcare providers, patients, and family members to help prevent infection. Partnering to Heal is a computer-based, video-simulation training program developed by the Department of Health and Human Services that highlights these themes of communication and creation of a patient safety culture. Users assume the identity of one of five main characters and make decisions about preventing HAIs in the hospital setting.