Expert Emphasizes the Role of Hand Hygiene, Contact Precautions and Cleaning in HAI Prevention

Healthcare-associated infections (HAIs) represent a growing concern for both patients and healthcare providers across the nation. The Centers for Disease Control and Prevention (CDC) estimates that approximately 1.7 million HAIs occur each year and contribute to the death of 99,000. Additionally, HAIs are the fourth leading cause of death in the United States, resulting in the death of more people annually than AIDS, breast cancer and auto accidents combined.

National infection prevention expert Ruth M. Carrico, PhD, RN, CIC, an assistant professor with the University of Louisville School of Public Health and Information Sciences, emphasizes that creating and maintaining a hygienic environment is everyones responsibility and teamwork is an important part of the process. Success requires a broad approach, including adherence to the following measures:

- Hand hygiene: The first step for prevention is vigorous monitoring of hand hygiene practices and heightened attention toward increasing hand hygiene rates. Educating staff and visitors of these practices is crucial to reducing the spread of HAIs.

- Isolation and surveillance: Once a patient experiences symptoms that may be associated with infection transmission, such as diarrhea, they should be isolated immediately. An assessment should be performed to determine the cause.

- Contact precautions: All staff entering the isolation environment should be instructed to wear the proper protection equipment. For C. difficile, this includes gowns and gloves. Visitors should also be educated and encouraged to frequently wash their hands and wear the protective gown and gloves when in the patient environment.

- Environmental cleaning and disinfection: Cleaning the environment and using an appropriate disinfectant is critical to helping prevent the spread of pathogens that cause HAIs and protecting the well-being of patients. The use of a product that is registered by the U.S. Environmental Protection Agency (EPA) for proven efficacy claims is crucial. Bleach is approved by the U.S. Environmental Protection Agency (EPA) to kill many types of problematic organisms including C. difficile spores. Using a 1:10 bleach solution as a disinfectant is included in recommendations by APIC, SHEA and CDC to address the challenge of C. difficile.

"Each of these steps may seem like they are easy to implement, but ensuring consistent application of improvements and the rapid addressing of practice deviations take time and attention," says Carrico. "Recognizing that everyone has a stake in improving activities and ideas for successful and sustainable implementation should come from those involved in the process."

With more than 30 years of experience in healthcare, Carrico has focused her practice toward issues dealing with infection prevention in the healthcare and public health sectors and is board certified in infection control. She has received training specific for healthcare epidemiology and public health at the Centers for Disease Control and Prevention (CDC) in conjunction with the Rollins School of Public Health at Emory University in Atlanta and the Society for Healthcare Epidemiology of America (SHEA).

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