Healthcare-Associated Infections _ ______________________________________________________________
SUMMARY OF PREVENTION MEASURES FOR THE MOST COMMON HEALTHCARE-ASSOCIATED INFECTIONS
Type of Infection
Evidence-Based Recommended Measures Appropriate hand hygiene Meticulous aseptic technique for devices and equipment Indwelling catheters only when needed Proper securing of catheter Closed sterile drainage system Unobstructed urine flow Removal of catheter as soon as possible Deep breathing Frequent coughing Early movement (in bed and/or walking) Limited use of narcotic agents Incentive spirometry (for patients at high risk) Elevation of the head of the bed (30 degrees) a Daily interruptions of sedation and assessment of readiness to extubate a Prophylaxis of peptic ulcer disease a Prophylaxis of deep venous thrombosis a
Other Suggestions
All infections
—
Catheter-associated urinary tract infection
Alternative to indwelling catheter (suprapubic, condom) Antimicrobial-coated catheter Hand-held bladder scanners
Pneumonia (without mechanical intubation)
—
Ventilator-associated pneumonia
Endotracheal tube with a dorsal lumen Noninvasive ventilation
Surgical site infection Appropriate antibiotic prophylaxis Avoidance of preoperative shaving
Performance feedback to surgeons
Maintaining adequate glycemic control Maintaining a warm body temperature
Maximal barrier precautions a 2% chlorhexidine solution for skin antisepsis a Selection of optimal site for the catheter (subclavian vein preferred for nontunneled catheters) a Daily review of the need for the line, with prompt removal if line is deemed unnecessary a Judicious use of antibiotics Barrier precautions (gowns and gloves, dedicated or disposable equipment, cohorting of patients and/or staff) Handwashing with soap and water (alcohol is not effective against C. difficile spores) Appropriate disinfectant for surfaces and devices
Intravascular device- related bloodstream infections
Catheter with antimicrobial coating Performance feedback to personnel
Clostridioides difficile - associated diarrhea
—
a Component of a bundle of interventions that, when implemented together, has lowered the rate of infection. Source: Compiled by Author
Table 22
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