4 Patients who are acutely unwell have increased susceptibility to infection due to accidental or surgical injuries, multiple invasive devices, decreased immunity, complex health problems and increased contact with healthcare staff. Therefore, healthcare-associated infection (HCAI), prevention and control in critical care is of paramount importance. Whilst twenty-first century healthcare can bring even the sickest and most traumatised patient back from the brink of death, a single infectious agent can enter the body and bring about death in a matter of hours. The National Point Prevalence Study (2011) on healthcare-associated infection,1 gives a ‘snapshot’ of the overall HCAI prevalence rate (the number of people suffering from a HCAI during the time of the study); it shows a prevalence rate of 6.4, a reduction from 8.2. Figure 4.1 highlights the six most common types of HCAI which account for more than 80% of all HCAIs. Every single act or intervention has the potential to spread infection, as microorganisms invisible to the naked eye can be moved from place to place, and person to person, resulting in entry to a susceptible host (patients or staff) through any orifice or break in the skin. Standard precautions rely on staff assessing the risk of the ‘task’ they are carrying out and deciding on the appropriate precautions that should be taken and where these are considered insufficient, implement additional ‘transmission-based precautions’ (Figure 4.2).2 Following these recommended guidelines will not only prevent patients from becoming infected but also staff from occupationally acquired infections.
Hospital-acquired infection: infection prevention and control
Infection prevention and control
Standard and transmission-based precautions
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