Chapter 6 - Review of current practice in preventing health care associated infections

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Health-care-associated infections (HAIs) are a significant problem in all health-care facilities and in all units of the health-care facility. This chapter outlines the scope of the problem with HAIs, types of HAIs, and prevention of HAIs. The chapter discusses the background and history of HAIs. This includes assessing the risk and impact of getting an HAI including multidrug-resistant organisms, patient characteristics, and procedural characteristics. HAIs are categorized as non-device associated, device associated, and surgical site infections. The chapter also looks specifically at device-associated infection. This includes industrial single-use devices such as urinary and intravenous catheters, as well as reusable devices such as surgical instrumentation. In the section on surgical site infection, surgical asepsis and airflow/ventilation are also discussed. The section on preventing HAIs details the steps that can be taken in terms of behavioral, procedural, and engineering solutions. Behavioral solutions include: isolation precautions, surgical hand scrubs, and health-care personnel attire. Procedural solutions include: use of antimicrobials, surgical clippers, postoperative glucose control, postoperative normothermia, WHO Safe Surgery Saves Lives Initiative, and CDC SSI Guideline 1999. Engineering solutions include: suite/room design, protection and barriers, cleaning, disinfection, and sterilization.