• Strategies for reduction of HAIs
  • Zero tolerance policy
  • Hand Hygiene Improvement
  • Environmental surveillance
  • Priority of lines and drains 
• Drivers to prevent re-occurrence 
  • Patient pressure, regulations, fear of legal action, financial assistance, and governing guidelines. 
• Reducing morbidity and mortality rates
  • Preventing them before they happen 

• Central-line associated bloodstream infections (CLABSI)
• Clostridium difficile infections
• Pneumonia
• Methicillin-resistant Staphylococcus aureus (MRSA) infections
• Surgical site infections
• Urinary tract infections

• Environment:
  • Poor hygiene conditions and inadequate waste disposal 
• Susceptibility:
  • Prolonged antibiotic use, prolonged stays, immunocompromised patients, Central lines, and the elderly. 
• Unawareness: 
  • Poor knowledge of disinfection and sterilization techniques
  • Inappropriate use of invasive devices
  • Lack of control policies
• Transmission
  • Bacteria transferred to surgical site
  • Staff to patient 
  • Equipment transmission 

• Infection control programs
  • Standard precautions
  • Transmission based precautions
  • Guidelines for the sterilization and disinfection of invasive devices 
• Antibiotic control policy
  • Avoid antimicrobial overuse and the misuse of antibiotics
• Changing the culture of an organization so that everyone can speak up if they detect unsafe practices 

• Following the Universal Precaution Rule
  • Wearing personal protection equipment (PPE) such as gloves, gowns, and face mask/shield. 
  • Full barrier precautions when preparing for the insertion and cleaning of central venous catheters
• Effective hand-washing with antimicrobial soap and water or alcohol based sanitizer in between patient care
• Irrigating cutaneous wounds thoroughly between dressing changes and dressing a wound appropriately
• Adopt a safety minded attitude and report errors immediately  

• 32 percent of all healthcare acquired infection are urinary tract infections
• 22 percent are surgical site infections
• 15 percent are pneumonia (lung infections)
• 14 percent are bloodstream infection

"Patients who acquire infections from surgery spend, on average, an additional 6.5 days in the hospital, are five times more likely to be readmitted after discharge and twice as likely to die." (Healthcare-Acquired Infections (HAIs), 2018, para 1). 

"These infections occur worldwide both in developed and developing countries. Nosocomial infections accounts for 7% in developed and 10% in developing countries." (Khan, Beig, & Mehboob, 2017, p. 478).   

"By leading and participating in prevention efforts, nurses can play a major role in reducing these infections. Recently, nurses have been collaborating with infection preventionists, physicians, quality-improvement specialists, pharmacists, and others to significantly decrease HAIs and reduce their impact on patients, families, nurses and other caregivers, and hospital bottom lines. " (Hessels, 2015, p. 2). 

• Creating a system to monitor healthcare workers' handwashing practices without creating a system in which workers instinctively wash their hands only when the monitors – whose identities will quickly become known – are present.  
• Identifying selected antibiotic-resistant nosocomial pathogens
  • MRSA, C. diff 
• Identifying agents of nosocomial infections before they are spread from patient to staff to other patients. 
  • Staphylococcus, E. coli, K. pneumonia, P. aeruginosa
• Having visitors and patients comply with universal precautions to prevent environmental contamination
•  Decisions to decolonize certain patients, discovered to be carriers, with antibiotics create the risk of emergence of resistant bacterial strains.   

• For universal precautions, protective barriers reduce the risk of exposure to blood, body fluids containing visible blood, and other fluids to which universal precautions apply. Examples of protective barriers include gloves, gowns, masks, and protective eyewear.
• Always wear a protective barrier (surgical gloves) when in contact with blood, body fluids or feces.
• Assess the need for isolation: Neutropenia and immunological disorder, diarrhea, skin rashes, known communicable disease, & known carriers of an epidemic strain of bacterium. 
• According to Hillyard (2009), we must always follow these 5 steps:
  • Patient and staff education 
  • Hand washing 
  • Use of protective barriers (Personal Protective Equipment (PPE)) 
  • Cleaning of contaminated surfaces 
  • Safe handling/disposal of contaminated material

• Nurses in all roles and settings can demonstrate leadership in infection prevention and control by using their knowledge, skill and judgment to initiate appropriate and immediate infection control procedures. Practice diligently and keep your patient safe. 
• Advocating for patient safety through handwashing and enforcing strict handwashing when required 
  • "All Hands on Deck" 
• Educate patients on why we use precautions and explain procedures and interventions of care for them.