4 Ways to Improve Infection Prevention in Your Hospital

Michelle Vignari
Michelle Vignari RN, BSN, CIC

By Michelle Vignari RN, BSN, CIC
Infection Preventionist, Independent Infection Prevention Consultant

Prioritizing how and where to prevent hospital infections is easier said than done. With threats to patient safety in and out of the front door daily, where to focus your attention and remain consistent can be a challenge. Implementing a series of infection prevention (IP) procedures that are enforced and followed by every member of every department will allow your hospital to operate without disruption. But how does your team decide on which IP strategies to employ? The best first course of action is to ensure the basics are being implemented to success throughout your hospital system.

#1: Hand Hygiene 

Yes, hand washing might be the simplest approach to preventing the spread of infections, but its importance cannot be stated often enough by and to even the most senior members of any hospital. The CDC goes as far as saying it should be incorporated into the entire culture of an organization. While hospital personnel might have hand hygiene down to a science, incorporating signage on the importance of hand washing throughout the hospital will impart that message to patients and visitors, critical stakeholders in IP practices.  

Many infection preventionists recommend a “clean in, clean out” approach, wherein hands and equipment are cleaned or disinfected on the way into the patient’s room and on the way out again. 

#2: Cleaning & Disinfection  

Manual cleaning and disinfection is a key element of a bundled IP approach. The hospital environment is predisposed to harbor potential pathogens given the volume of sick patients, the pace and acuity of patient care activities performed by healthcare workers, and the complexity of hospital surfaces and medical equipment requiring routine cleaning (Doll et. al 2018).  Effective cleaning with an EPA approved disinfectant of environmental surfaces and patient care equipment is a fundamental piece in breaking the chain of infection in healthcare. In reducing environmental bioburden, potential contribution to the incidence of healthcare-associated infections is decreased.

Cleaning and disinfection will reduce, but often does not eliminate, dangerous pathogens. A study in BMJ Journals showed that of 1,917 patient rooms cleaned using standard processes and detergent, nearly 25 percent still contained strains of MRSA. This finding suggests hospitals cannot rely on manual cleaning alone to fully eradicate pathogens and deter HAIs. This is where a bundled approach that includes UVC disinfection becomes an essential tool. 

#3: UVC Disinfection

A powerful way to succeed at IP is to incorporate UVC disinfection systems. Bundled with traditional manual cleaning and sterilization, UVC technology increases the effectiveness of a hospital’s IP protocol by harnessing ultraviolet light to target and destroy pathogens that can potentially harm patients. This process renders C.diff, MRSA and other deadly pathogens unable to replicate and halts their spread. If the pathogens that cause healthcare associated infections (HAIs) cannot spread, then the risk of patients becoming infected drops.

The most effective UVC systems measure UVC dosage received at targeted areas, using multiple sensors placed throughout a room (versus less effective systems that rely solely on timed exposure). UVC systems that monitor actual dosage capture and distribute disinfection data in real-time, enable IP personnel to record and share performance data for efficacy reporting. While the technology is advanced, operating these systems is designed to be user-friendly and straightforward. The easier it is to use a UVC disinfection system, the more likely it is to be effectively employed, thus reducing HAIs. 

#4: Hospital-Wide Integration

As organizations strive for high reliability in a world of value-based purchasing and public reporting of key infection statistics, disciplines need to work together to find solutions that best serve their patients throughout the hospital system. Hospitals should prioritize their infection prevention plan across all departments to reduce the threat of infection among patients, staff, and to reduce financial risk.  

The most effective model includes engagement by a comprehensive infection prevention team, made up of staff from all areas of the hospital including environmental services. This allows each group to understand that they have something to offer, not operate in silos, or feel that there is any blame for negative outcomes. As hospitals and health systems increasingly recognize the financial incentive to boost IP efforts, this type of approach ensures the entire system is addressing IP versus only one department. 

The last thing a patient expects when they enter a hospital is to leave feeling worse than when they arrived. Patients put their trust in hospital staff across all departments, but HAIs remain an all-too-common occurrence. A comprehensive organizational approach should be adopted, one which ensures the most basic of IP procedures is being implemented with fidelity. A hospital’s infection prevention plan can only reach maximum effectiveness when all departments are on board with the infection prevention program. When it’s not, the results can be detrimental to hospitals and patients.