Healthcare-Associated Infections (HAI) Prevention
Standard Precautions
- Hand hygiene is the single most important intervention to prevent HAIs and must be performed before and after every patient contact, after removing gloves, and after contact with contaminated surfaces.
- Personal Protective Equipment (PPE) includes gloves, gowns, masks, and eye protection, worn based on anticipated exposure to blood, body fluids, secretions, and excretions.
- Safe injection practices require using sterile, single-use disposable needles and syringes for each injection, and never reusing or sharing needles between patients.
Key Points
- Standard precautions apply to ALL patients regardless of diagnosis
- Hand hygiene timing: WHO's "5 Moments" - before patient contact, before aseptic procedures, after body fluid exposure, after patient contact, after contact with patient surroundings
Transmission-Based Precautions
| Type | PPE Required | Examples |
|---|
| Contact | Gown + Gloves | MRSA, C. diff, VRE |
| Droplet | Surgical Mask | Influenza, Pertussis |
| Airborne | N95 Respirator | TB, Measles, Varicella |
Memory Aid: PPE Removal Order
"GFGM" - Gown, Face shield/goggles, Gloves, Mask (most contaminated to least contaminated)
Specific HAI Prevention Strategies
Central Line-Associated Bloodstream Infections (CLABSI)
- Perform hand hygiene and use maximal sterile barrier precautions during insertion
- Use chlorhexidine skin antisepsis at insertion site
- Select optimal catheter site (avoid femoral vein in adults)
- Remove unnecessary catheters daily during rounds
- Maintain sterile dressing and change per facility protocol
Catheter-Associated Urinary Tract Infections (CAUTI)
- Insert urinary catheters only when medically necessary and remove as soon as possible to minimize infection risk.
- Maintain a closed drainage system and keep the drainage bag below the level of the bladder to prevent reflux of urine.
- Perform routine perineal hygiene with soap and water, avoiding harsh antiseptics that can disrupt normal flora.
Critical Alert: Never disconnect the catheter from drainage tubing to obtain urine specimens - use the sampling port with sterile technique
Surgical Site Infections (SSI) Prevention
- Preoperative skin preparation includes patient showering with antiseptic soap and surgical site hair removal with clippers (never razors) immediately before surgery.
- Maintain normothermia (36-38°C) throughout the perioperative period as hypothermia increases infection risk by impairing immune function.
- Administer prophylactic antibiotics within 60 minutes before surgical incision (120 minutes for vancomycin) to achieve therapeutic tissue levels.
SSI Risk Factors Memory Aid
"DIABETIC" - Diabetes, Immunosuppression, Age >65, Blood loss, Emergency surgery, Tobacco use, Infection elsewhere, Contaminated wound
Study Tips & Memory Aids
Hand Hygiene Duration
Alcohol-based hand rub: 15-20 seconds until dry
Soap and water: 20 seconds (sing "Happy Birthday" twice)
Common Pitfalls to Avoid
- Don't assume all respiratory infections require airborne precautions - most need only droplet
- Remember: Alcohol-based hand rubs are NOT effective against C. difficile spores - use soap and water
- Never recap needles - use one-handed technique or safety devices only
Self-Assessment Checklist
- □ Can I identify the correct PPE for each transmission-based precaution?
- □ Do I know the proper sequence for donning and doffing PPE?
- □ Can I explain the difference between standard and transmission-based precautions?
- □ Do I understand specific interventions for preventing CLABSI, CAUTI, and SSI?