A sharply increased focus on hospital-acquired infections (HAIs).

This month marks the 14th anniversary of the National Healthcare Safety Network (NHSN), the CDC’s data repository for health care–associated infections. Since 2005, when a limited number of hospitals began reporting infections data, the health care community has sharply increased its focus on the prevention, early recognition, and treatment of infections in the hospital. Research on risk factors, closer attention to limiting device use (urinary catheters, central lines), and support for meticulous hand hygiene and environmental cleaning protocols have decreased rates of CAUTIs, CLABSIs, and surgical site infections.

The risk is always there.

Still, as nurses well know, hospitalized patients remain at increased risk for developing infections, especially if they are immunosuppressed or have diabetes, need invasive devices, have many comorbidities, or stay in a critical care unit.

The current evidence reviewed.

In “Infection in Acute Care: Evidence for Practice” in this month’s AJN, Douglas Houghton reviews the latest evidence on common infections in acute care settings, including community- and hospital-acquired pneumonia, surgical site infections, and C. difficile.

Houghton also briefly addresses multidrug-resistant organisms, and the rare but aggressive necrotizing fasciitis that can complicate surgical site infection.

“Clinical findings suggestive of necrotizing fasciitis include excessive pain or tenderness [at the site], fever, soft-tissue edema, and skin bullae or necrosis… If necrotizing fasciitis is suspected, immediate consultation with a surgeon experienced with this infection is warranted….”

Key measures to prevent and control HAIs.

After this reminder of the serious and often fatal consequences of “routine” hospital-acquired infections, Houghton reviews key measures that can prevent and control infection, especially

  • excellent hand hygiene and adherence to contact precautions.
  • following antibiotic stewardship protocols.
  • promoting a clean environment.
  • recognizing early signs of infection.

Read more of the latest evidence base for the prevention and treatment of hospital-related infections. The article is free to read, and 1.5 CE credits are available.