Infection Control in Hospitals: Best Practices

Hospital-acquired infections (HAIs) pose serious threats to patient safety, but following strict prevention protocols at all levels can effectively protect vulnerable patients. This article provides expanded explanations around key evidence-based infection control strategies for optimal contamination prevention across healthcare settings.

Hand Hygiene Compliance

Hand hygiene remains the most critical procedure for reducing HAIs. All staff must wash hands thoroughly with soap and water or alcohol-based sanitizer before and after each patient contact. Rings, bracelets and long nails harbor pathogens and should be addressed. Proper hand washing technique entails lathering all surfaces for a minimum 20 seconds followed by thorough rinsing. Alcohol rubs must cover all areas of hands until dry.

Compliance should be monitored secretly by trained observers tallying lapses with feedback to enhance motivation and accountability. Hand hygiene resources require easy access in every patient zone with ample supplies consistently maintained. Visual signage at point-of-use along with occasional reinforcement reminders during staff huddles or emails encourage habitual hygiene.

Surface Disinfection

High-touch environmental surfaces like medical tools, bed rails, infusion pumps and overbed tables readily transfer pathogens between patients. After identifying key objects per room, surfaces should be pre-cleaned manually to remove dirt before disinfectant application. EPA-registered disinfectants specifically tested against nosocomial organisms like MRSA must be used noting any required dilutions, adequate wetting and sufficient surface contact times per label.

Fluorescent markers and cleaning monitors help assess housekeeping quality while routine microbiological cultures detect overlooked hotspots. Recent UV technologies also enhance terminal disinfection against stubborn spore-forming organisms.

Patient Isolation Precautions

Patients diagnosed or suspected of certain infections require isolation until no longer contagious. Contact precautions for multidrug-resistant organisms like MRSA necessitate gloves and gowns for room entry while droplet precautions for influenza mandate masks within 3-6 feet. Airborne isolation for measles or TB warrants negative-pressure rooms preventing air leakage and specialized N95 respirators. Signage on room doors clearly indicate isolation categories.

Dedicated medical equipment helps contain organisms. Targeted patient-specific education before discharge or transfer facilitates continuity of precautions for ongoing protection.

Sterilization of Instruments

Surgical instruments including endoscopes and bronchoscopes require meticulous multi-step cleaning based on device intricacy before sterilization. Manufacturer guidelines detail compatible chemicals avoiding damage. After manual scrubbing, ultrasonic cleaners dislodge soil from crevices aided by enzymatic solutions to dissolve organics, followed by rinsing then drying to avoid residual buildup.

Packaged instruments then undergo steam sterilization either by pre-vacuum autoclaves or gravity displacement varieties based on item compatibility. Biological indicators using Geobacillus stearothermophilus spores definitively confirm sterilizer efficacy. Proper loading, unloading and transport techniques preserve integrity. Storage shelving should be moisture-free with items wrapped and dated.

Air Quality and Ventilation

Indoor air balances containment against adequate dilution. Care areas with higher infection risks or immunocompromised patients require heightened ventilation rates (6-12 ACH) and additional air exchanges. Directional airflow patterns strategically route contaminants away from clean zones. High-efficiency particulate air (HEPA) filters remove hazardous particles while laminar flow contains buildup. Ultraviolet germicidal irradiation (UVGI) inactivates air and surface microbes. Humidity levels ideally range from 40-60%. Negative pressure isolation areas restrict expelled contaminants. Real-time monitoring ensures sustained quality.

Water Safety

Waterborne pathogens like Legionella, fungi and NTM (non-tuberculous mycobacteria) lurk within premise plumbing and cooling tower reservoirs risking respiratory, wound and bloodstream infections. Hot water should be stored above 140°F and circulated above 124°F limiting microbial growth while cold water must stay below 68°F. Chlorination, copper-silver ionization and UV treatment control contamination but require residual disinfection benchmarking at the tap to verify efficacy. Stagnation spurring biofilm buildup necessitates fastidious flushing of unused supply lines. Fixture cleaning and water testing for Legionella pneumophila every 1-3 months provide operational oversight.

Waste Management
Medical waste handling minimizes exposure to hazardous sharps, biological substances or radioactive materials. Waste streams should remain segregated using designated color-coded leak-proof containers with tight lids and liner bags. Trained staff must safely transport filled containers to secured storage areas awaiting proper onsite treatment or offsite incineration guided by state regulations, wearing PPE to prevent spills or sharps injuries.

Antimicrobial Stewardship

Up to 50% of antibiotic prescriptions prove inappropriate or ineffective fueling multidrug resistance threatening patient mortality. Each hospital pharmacist-led antimicrobial stewardship team surveils local microbiological patterns and drug sensitivities helping clinicians make informed prescribing decisions through preauthorization requirements and therapy recommendations. Order sets standardize appropriate antibiotic selection, dosing, de-escalation and duration. Monitoring prescription practices provides prescribing feedback opportunities. Patient education also supports appropriate self-care expectations.

Conclusion

Preventing deadly infections remains paramount to safe patient care. While daunting, hospitals committed to bolstering hygiene compliance, disinfection protocols, isolation practices, equipment handling, facility operations and antimicrobial oversight can successfully safeguard patients from pathogens and drug-resistance. Infection control requires interdisciplinary vigilance across diverse responsibility areas within any healthcare institution to continually optimize risk reduction.