What’s Lurking in the Sink? Rethinking Water as an Infection Risk in Health Care

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Nurses play a primary role in patient safety through direct care and through the environments in which care is delivered. While clinical responsibilities are well defined, the nurses’ role in promoting a health care environment that prevents health care–associated infections (HAIs) is not always clear.

A recent report from the Centers for Disease Control and Prevention (CDC) revealed that U.S. hospitals saw meaningful declines in several major HAIs in 2024, including Clostridioides difficile (C. diff) infections, catheter-associated urinary tract infections (CAUTIs), central line–associated bloodstream infections (CLABSIs), and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia. Despite the obvious progress, each day, approximately one in 31 hospitalized patients and one in 43 nursing home residents contract at least one HAI in association with their health care. This alarming statistic underscores the need for frontline vigilance by nurses in every clinical setting.

When the Environment Works Against Us

Infection prevention is often framed around what we can see—dirty floors and high-touch surfaces, visibly soiled equipment, and stained linens. Some of the most consequential risks in health care are not visible. One emerging area of concern is the role of health care water systems as reservoirs for pathogens. Surprisingly, it’s not dirty water that’s being scrutinized, but […]

2026-04-08T10:03:07-04:00April 8th, 2026|infection control, Nursing|0 Comments
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Multidrug Resistance: A Growing Threat of Carbapenem-Resistant Gram-Negative Organisms in Health Care

Nurses are well aware of the problems with multidrug-resistant organisms (MDROs) and their ubiquitous presence across health care settings. Care issues and outcomes among patients with MDROs such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), and Clostridioides difficile (C. diff) have increased awareness, but MDROs remain a growing challenge in the provision of care in virtually all health care settings.

Carbapenem-resistant Gram-negative bacteria, another example of MDROs, have emerged as one of the most urgent public health challenges globally. Organisms such as carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPA), and carbapenem-resistant Acinetobacter baumannii (CRAB) are associated with high morbidity, mortality, prolonged hospitalization, and limited treatment options. According to the World Health Organization (WHO), carbapenem-resistant A. baumannii and carbapenem-resistant Enterobacterales are among the highest-priority pathogens due to their rapid spread and severe clinical consequences (WHO, 2024).

Mechanisms of Carbapenem Resistance

Carbapenem resistance develops when bacteria change in ways that allow them to survive despite antibiotic treatment. Nurses and other health care personnel benefit from understanding these mechanisms because they directly relate to infection prevention activities, equipment cleaning and disinfection, and antimicrobial stewardship efforts.

Examples of how resistance develops are outlined below:

  1. Bacteria Produce Enzymes That Break Down the Antibiotic (Carbapenemase production)

Some bacteria create special enzymes that destroy carbapenem antibiotics before they can work. These are called carbapenemases. Common types of these enzymes include KPC (Klebsiella pneumoniae carbapenemase), NDM (New Delhi metallo-beta-lactamase), VIM (Verona integron-encoded metallo-beta-lactmase), IMP (Imipenemase metallo-beta-lactamases), and OXA-48 (Oxacillinase-48).  These enzyme abbreviations/names may be familiar, as they have been seen […]

2026-01-05T11:14:29-05:00January 5th, 2026|infectious diseases, Nursing, Public health|0 Comments
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Ticks and Tick-Borne Diseases: A Comprehensive Nursing-Focused Overview

Virtually all of us who have spent time in the outdoors have either heard about or experienced an encounter with a tick. Diseases transmitted through the bite of a tick represent a growing health concern in the United States and around the world. Tick bites can affect individuals who live in, work in, or travel to wooded, grassy, or brush-filled environments. Ticks are generally more active during warmer months of the year (usually April through September), but they can be active any time the temperature is above freezing. Therefore, taking precautions can be close to a year-round activity, including an increased emphasis during vacation travel when the climate may differ from that of your usual environment. Nurses play an essential role in patient education, prevention, early recognition, clinical management, and public health surveillance of these diseases—and their credibility and trusted relationships enable impactful opportunities.

Adult deer tick, Ixodes scapularis/via Wikimedia Commons

The following summary outlines key facts about tick biology and transmission, clinical manifestations of major tickborne diseases [TBDs], prevention strategies, post-bite care, public health reporting, and updates on vaccines—particularly for domestic and international travelers.

Understanding ticks and disease transmission

Ticks are blood-feeding arachnids capable of transmitting pathogens, including bacteria, viruses, and protozoa, through […]

2025-08-25T11:04:09-04:00August 25th, 2025|infection control, infectious diseases, Nursing, Public health|0 Comments
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H5N1 Avian Influenza (Bird Flu) Update for Nurses and Other Health Providers

Influenza is a clever virus and one that deserves respect. Current concerns with the H5N1 avian influenza virus strain demonstrate why public health around the world continues to watch and monitor for impact on human health. Although the situation is not one that currently affects us on a day-to-day basis, it is important that we have a basic understanding of why this remains newsworthy.

Spread and evolution of H5N1.

Since its emergence, H5N1 has spread across multiple continents, affecting wild birds, poultry, and mammals. In late 2023, the virus was detected in Antarctica for the first time, raising concerns about its impact on native wildlife. By 2024, H5N1 had been reported in various regions, including Europe, Asia, and the Americas, leading to significant poultry losses and economic challenges.

In the United States, H5N1 has been detected in wild birds, poultry, and mammals across all 50 states. As of early 2025, nearly 70 human cases have been confirmed, primarily among individuals with direct exposure to infected animals. In December 2024, the Centers for Disease Control and Prevention (CDC) confirmed the first severe human case of H5N1 in Louisiana, involving a patient hospitalized with severe illness.

We have seen H5N1 move across nonhuman animal species, to situations where humans have become mildly ill after contact with animals, and now to situations where animal contact has resulted in severe human illness.

Since this particular strain of influenza has been detected in a variety of animals, but rarely in humans, what is the concern? The concern […]

2025-02-13T12:42:43-05:00February 13th, 2025|infection control, infectious diseases, Nursing, Public health|0 Comments
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RSV Prophylaxis for Infants and Children: Now Available, But Is it Accessible?

July, a month typically characterized by the relative hibernation of communicable respiratory illnesses, brought with it the U.S. Food and Drug Administration’s (FDA’s) approval of nirsevimab-alip (brand name: Beyfortus) and thus a reminder of the gearing up necessary for the respiratory disease season ahead. Nirsevimab, approved for the prevention of respiratory syncytial virus (RSV), is poised to mitigate the staggering effects of this lower respiratory tract disease. Since significant barriers remain related to distribution, accessibility, and insurance reimbursement for this drug, it is especially important for primary care RNs and nurse practitioners in clinics and medical homes to be well informed on this topic.

RSV: a significant public health burden.

Transmission electron microscopic image revealing morphologic traits exhibited by a human respiratory syncytial virus (RSV)/ CDC

RSV is primarily of concern in the youngest and most vulnerable of the pediatric population, such as those born prematurely, with chronic lung or congenital heart disease. As many of us know all too well, RSV carries significant public health burden, causing more hospitalizations than any other illness in U.S. infants and accounting for 100 to 300 deaths each year in children under five years […]

2023-09-21T11:10:58-04:00September 21st, 2023|infectious diseases, Nursing, pediatrics, pediatrics|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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