Infection prevention and control (IPC) is critical in hospitals, clinics, nursing homes, and other healthcare facilities. Patients in these settings are at risk for contracting infections during their stay. At the same time, the healthcare staff also may be exposed to infectious diseases such as HIV, hepatitis B and C, TB, and respiratory viruses.
Healthcare facilities play an important role in managing illnesses but they also present increased risk for spreading healthcare-associated infections (HAIs) through cross-infection. To prevent HAIs, it’s critical to understand and implement effective IPC strategies. In this blog, we discuss both the standard precautions, such as hand hygiene and PPE, as well as innovative new technologies that could reduce the risk of HAIs even further.
Understanding Infection Risks in Healthcare Settings
According to the National Institutes of Health, HAIs are infections acquired after hospitalization and manifesting 48 hours after admission to the hospital. The six main HAIs include catheter-associated urinary tract infections, central line-associated bloodstream infections, surgical site infections, ventilator-associated pneumonia, hospital-acquired pneumonia, and Clostridium difficile (intestinal) infections.[i]
Patients most at risk for HAIs are those in already weakened conditions, such as older people, as well as those with implanted devices, recent surgeries, and long hospital and ICU stays.
Once acquired, HAIs can spread throughout healthcare settings by aerosol droplets or direct contact with staff, other patients, or contaminated surfaces, such as handrails, mobile carts, or medical equipment.
Key Elements of Infection Prevention Control
IPC has a priority for preventing HAIs in healthcare facilities. And the commonsense first level of IPC is hand hygiene. Proper handwashing and drying before and after contact with patients is the most important method for preventing the spread of disease.
Personal protective equipment (PPE)
When working with patients who are already infected or performing surgery or invasive tests, medical staff are required to use personal protective equipment (PPE). This may include disposable gloves, gowns, shoe coverings and cloth masks, as well as face shields and properly fitted N-95 masks.
Cleaning and disinfection
Proper cleaning and disinfection of surfaces such as trays, handrails and IV poles, as well as reusable medical instruments is also critical. The disinfectants used, whether alcohol, bleach, hydrogen peroxide, or other chemicals, should be appropriate to the type of surface or equipment and the possible contaminants.
Finally, healthcare professionals must know and understand the relative need for isolation of patients who are already infected or who are most at risk. This should include appropriate infection control training for all staff and isolation of patients presenting with an infectious condition.
Innovative Approaches to IPC: The Role of Technology
While the four elements discussed above comprise the current standard for preventing and managing infectious disease, new methods based on advanced technologies may lead to continued improvements in IPC.
Ultraviolet (UV) based technology is a relatively new method for disinfecting bacteria and viruses in healthcare settings and automated monitoring systems also may help reduce HAIs in several ways.
Technology to Reduce Risks
In this digital age, more and more automation technology is being developed to help reduce the spread of infection. For example, an electronically measured hand hygiene system installed in a hospital or other healthcare facility can track adherence rates over time and compare them to the incidence of HAIs in those facilities, in order to educate staff and ensure compliance.[ii]
In the public health arena, the CDC maintains a U.S. influenza surveillance system collaboratively with its many partners. This automated monitoring system collects data on influenza-like illnesses from laboratories and healthcare facilities across the country, and provides the most recent data on outbreaks, to help in decision-making.[iii]
UV light in the 240-280 nm wavelength range is proving useful for disinfection in healthcare settings. For example, autonomous robots are now using UV technology to disinfect entire medical wards. And UV technology, such as the UV Smart D60 can provide guaranteed automated high level disinfection of certain medical instruments in a matter of seconds, without the need for gallons of water, strong chemicals or consumables.
Benefits and Challenges of IPC in Healthcare Settings
The cost of healthcare-associated infections (HAIs), in both dollars and in human suffering, is enormous. The National Institutes of Health estimated that the current (2023) annual cost of treating HAIs in the United States ranges from $28.4 billion to $45 billion. One report estimated that “implementing comprehensive evidence-based infection control strategies could prevent hundreds of thousands of HAIs and save tens of thousands of lives and billions of dollars.”[iv]
The challenge to implementing new and more effective IPC strategies will be the cost of transitioning to new systems and equipment, as well as updated staff training. And as always, adherence to IPC procedures by staff and the public is key.
The Future of IPC in Healthcare: Reduced Risks through Technical Innovation
As our recent experience with the worldwide SARS-CoV-2 outbreak showed, the need for continuous efforts, innovation, and adherence to IPC protocols are critical to protect patients and healthcare workers alike.
The challenge may seem overwhelming, but the potential benefits are enormous, to patients and staff, to the economy, and to the public at large.