Preventing hospital-acquired infections in the ICU not only saves lives, it also saves money, according to a recent study published in the American Journal of Infection Control.
The study looked at two of the most common HAIs in critical care units – central line-associated bloodstream infections (CLABSI) and ventilator-associated pneumonia (VAP). Both are largely preventable. Researchers found that, on average, the cost of treating CLABSI is over $174K per patient, while for VAP it is over $163K. Yet the average cost of running an effective infection prevention program in the ICU is about $145,000 per year. Clearly, this tells us that we should continue to invest time and resources into implementing robust infection prevention policies!
Nurses play a vital role in minimizing the occurrence of HAIs. In fact, CDC guidelines include nursing-specific interventions for the prevention of each type of HAI. Many of these nursing interventions are considered core strategies – defined by the CDC as those that are backed by high levels of scientific evidence and have demonstrated feasibility. Some of them are surprisingly simple, like keeping the patient’s head elevated to prevent VAP and covering the patient with a sterile drape when inserting a central line to prevent CLABSI.
HAI Prevention Strategies for Nurses
All nurses should be aware of the “central line bundle.” The term refers to a group of five evidence-based strategies for the insertion and management of central lines. When implemented together, the bundled strategies result in better outcomes than when each strategy is implemented individually. In addition, the bundle approach promotes teamwork and collaboration among members of a multi-disciplinary care team.
The central line bundle has five key components:
- Good hand hygiene when accessing a catheter site for any reason
- Maximal barrier precautions when placing a central line
- Using chlorhexidine at the insertion site
- Choosing the catheter site carefully
- Removing central lines promptly when they are no longer necessary
Core strategies for preventing VAP focus on interrupting the three most common mechanisms by which it develops: the aspiration of secretions, the colonization of the aerodigestive tract, and the use of contaminated equipment. For nurses, this means practicing good hand hygiene, maintaining the patient’s oral hygiene, and maintaining the patient in a semirecumbent position, with the head of the bed elevated at an angle of 30 to 45 degrees, to help prevent aspiration.
Prevention as Patient Advocacy
Studies show clinicians don’t always reliably follow recommendations – like practicing good hand hygiene. Yet one of the most important ways you advocate for your patient is by following all protocols and reminding others to do so as well.
At the managerial or executive level, nurse leaders can advocate for patients’ safety by providing strong leadership when it comes to infection control and prevention polices. They can identify where policies are lacking, work to establish and promote needed protocols, and take the lead on ensuring that every member of the multi-disciplinary care team complies with them. As HAIs remain a hot topic in health care, strong nursing leadership – including at the executive level – will be instrumental in reducing their incidence.
The current, industry-wide focus on reducing HAIs is expanding career opportunities for nurses who want to specialize in infection prevention. Are you interested in keeping patients safe from pathogens in a hospital environment? If planning, implementing, and evaluating infection prevention and control measures appeals to you, consider making this in-demand field your career specialty. As a first step, you can develop new skills and empower yourself with knowledge through an online RN to BS/MSN or MSN degree with a specialization in infection control from American Sentinel University, an innovative, accredited provider of online nursing degrees.