Infection Prevention and Control: Simple Measures, Challenging Implementation
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The intensive care unit (ICU) is the hospital’s hot zone for healthcare-associated infection (HAI), especially ventilator-associated pneumonia, central line-associated bloodstream infection, catheter-associated urinary tract infection and surgical site infection. Evidence-based guidelines to prevent these Big Four are widely available, but healthcare professionals’ compliance is recognised as limited. This chapter discusses the basics of HAI prevention and proposes strategies to improve adherence to evidence-based prevention guidelines to promote a timely and successful ICU discharge by prevention of complications.
KeywordsHealthcare-associated infection Standard Precautions Ventilator-associated pneumonia Central line-associated bloodstream infection Catheter-associated urinary tract infection Surgical site infection Guideline adherence
- 1.World Health Organization. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. Geneva: World Health Organization; 2016.Google Scholar
- 4.European Centre for Disease Prevention and Control. Annual Epidemiological report for 2016—healthcare-associated infections acquired in intensive care units. Stockholm; 2018.Google Scholar
- 9.O’Grady NP, Alexander M, Burns LA, Dellinger EP, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections 2011 [updated 1 October 2017]. https://www.cdc.gov/infectioncontrol/guidelines/bsi/index.html. Accessed 27 May 2019.
- 10.Gould CV, Umscheid CA, Agarwal RK, Kuntz G, Pegues DA, The Healthcare Infection Control Practices Advisory Committee. Guideline for prevention of catheter-associated urinary tract infections 2009 [updated 15 February 2017]. https://www.cdc.gov/infectioncontrol/guidelines/cauti/. Accessed 27 May 2019.
- 13.Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 1999;27(2):97–132; quiz 3-4; discussion 96.CrossRefGoogle Scholar
- 14.World Health Organization. Global guidelines for the prevention of surgical site infection: WHO; 2016. https://www.who.int/gpsc/ssi-prevention-guidelines/en/. Accessed 27 May 2019.
- 15.Suetens C, Latour K, Karki T, Ricchizzi E, Kinross P, Moro ML, et al. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill. 2018;23(46):181122e1.CrossRefGoogle Scholar
- 18.European Centre for Disease Prevention and Control. Incidence and attributable mortality of healthcare-associated infections in intensive care units in Europe, 2008–2012. Stockholm; 2018.Google Scholar
- 21.World Health Organization. WHO guidelines on hand hygiene in health care. First global patient safety challenge clean care is safer care. Geneva: WHO; 2009. p. 270.Google Scholar
- 24.Talbot TRI, Stone EC, Irwin K, Overholt AD, Dasti M, Kallen A, et al. Recommendations on use of chlorhexidine-impregnated dressings for prevention of intravascular catheter-related infections: an update to the 2011 guidelines for the prevention of intravascular catheter-related infections from the Centers for Disease Control and Prevention. 2017. https://www.cdc.gov/infectioncontrol/guidelines/bsi/c-i-dressings/index.html. Accessed 27 May 2019.
- 26.National Institute for Health and Care Excellence (NICE). Surgical site infections: prevention and treatment, NICE guideline [NG125]. 2019. https://www.nice.org.uk/guidance/ng125. Accessed 22 Jul 2019.
- 32.Blot SI, Labeau S, Vandijck D, Van Aken P, Claes B, Executive Board of the Flemish Society for Critical Care N. Evidence-based guidelines for the prevention of ventilator-associated pneumonia: results of a knowledge test among intensive care nurses. Intensive Care Med. 2007;33(8):1463–7.CrossRefGoogle Scholar
- 34.Labeau SO, Vandijck DM, Rello J, Adam S, Rosa A, Wenisch C, et al. Centers for Disease Control and Prevention guidelines for preventing central venous catheter-related infection: results of a knowledge test among 3405 European intensive care nurses. Crit Care Med. 2009;37(1):320–3.CrossRefGoogle Scholar