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Hospital Infection Prevention: How Much Can We Prevent and How Hard Should We Try?

  • Gonzalo BearmanEmail author
  • Michelle Doll
  • Kaila Cooper
  • Michael P. Stevens
Healthcare Associated Infections (G. Bearman and D. Morgan)
Part of the following topical collections:
  1. Topical Collection on Healthcare Associated Infections

Abstract

Purpose of Review

To summarize the extent to which hospital-acquired infections (HAIs) are preventable and to assess expectations, challenges, and barriers to improve patient outcomes.

Recent Findings

HAIs cause significant morbidity and mortality. Getting to zero HAIs is a commonly stated goal yet leads to unrealistic expectations. The extent to which all HAIs can be prevented remains debatable and is subject to multiple considerations and barriers. Current infection prevention science is inexact and evolving. Evidence-based infection prevention practices are often incompletely implemented and at times controversial. Highly sensitive surveillance results in overdiagnosis, calling into question the real incidence of HAIs. Perceived reductions in HAIs by gaming the system lead to false conclusions about preventability and may cause harm. Successful HAI reduction programs require executive oversight yet keeping hospital leaders engaged in infection prevention is a challenge given competing priorities. Medicine is not a physical science with precisely defined laws; thus, infection prevention interventions are subject to variable outcomes.

Summary

Perhaps up to 55–70% of HAIs are potentially preventable. This is subject to a law of diminishing returns as the preventable proportion of HAIs may reduce over time with improvements in patient safety. As the principle tenet of medicine is first do no harm, infection prevention programs should relentlessly pursue reliable, sustainable, and practical strategies for heightened patient safety.

Keywords

Infection prevention Patient safety Implementation science Hospital epidemiology Public health Healthcare quality 

Notes

Acknowledgements

Authors would like to recognize Ms. Tina Olkonen for her assistance with preparing the final manuscript.

Compliance with Ethical Standards

Conflict of Interest

Gonzalo Bearman, Michelle Doll, Kaila Cooper, and Michael Stevens declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Gonzalo Bearman
    • 1
    Email author
  • Michelle Doll
    • 1
  • Kaila Cooper
    • 1
  • Michael P. Stevens
    • 1
  1. 1.Virginia Commowealth University Hospital Infection Prevention ProgramRichmondUSA

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