1. Running head: LITERATURE REVIEW 1
Literature Review
Maria S. Jiménez
Alvernia University
Abstract

2. LITERATURE REVIEW 2
A brief review of the literature hospital-acquired infections. The objective of the literature review
was to explore effective methods to reduce hospital-acquired infections.
Keywords: hand hygiene, infection control, infection prevention, infrastructure
Literature Review

3. LITERATURE REVIEW 3
Every year, many lives are lost because of the spread of nosocomial infections in hospitals.
Health workers can take steps to prevent the spread of infectious diseases. According to The
Centers for Disease Control and Prevention, 2 million patients suffer from hospital-acquired
infections every year, and nearly 100,000 of them die (Kemmerly, 2009). They say that most of
these medical errors are preventable. Studies show that the cost of the treatment of HAIs is
estimated at over $30 billion dollars a year just in the US alone (MacDonald, 2013).
In 1848, Ignaz Semmelweis established a link between the hands of health care workers and
the spread of hospital-acquired diseases. Semmelweis “came up with the idea of hand washing
and the use of an antiseptic solution for hands and surgical instruments” (Mangiadi, Marcovici,
2011). They ultimately rejected the idea because they believed the spread of infection was
caused by inadequate ventilation and stagnant air. On the other hand, Florence Nightingale
demonstrated that cleaning up the military hospital with fresh linens, rat poisons, and scrub-
brushed floors would result in a reduction of the death rates. There would be a reduction in
mortality from 40% to 2% in a matter of six months. Studies show that until the production of
penicillin in 1941, the percent levels of surgically acquired infections in hospitals were between
2-15%. But by late 1940s they found some penicillin-resistant strains. But by the late 1960s they
found that hospital infections were increasing. They believed it was because medical staff
became relaxed with the antiseptic techniques and the used too many antibiotics (Mangiadi,
Marcovici, 2011).
A hospital-acquired infection is a problem affecting patients, medical staff, and all the health
care system as well. According to the Centers for Disease Control and Prevention, one out of
every 20 hospitalized patients will contract a healthcare-associated infection (Vaidya, 2013).

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There are a series of strategies for infection prevention and control. Health care workers can take
steps to prevent the spread of infectious diseases. According to MacDonald 2013, hand washing
is the most simple and cost-effective approach to preventing the spread of infections. Hand
washing needs to be incorporated into the culture of the hospital system. As a result, medical
staff should wash their hands when they go in and out of a patient’s room and disinfect any
equipment and area where patients and care providers have touched with their skin (Vaidya,
2013). Studies show that in addition to hand and environmental hygiene, consistent screening of
patients should be included as part of the preoperative health evaluation. These patients should
then be treated prior to surgery or any other procedure. Sometimes healthcare providers will
contract infections while they are treating patients. Therefore, they too should keep vaccinations
up to date in order not to spread the disease to their coworkers. As another suggestion, an
infection surveillance program should be implemented to measure outcomes, assess the process
of care, and promote patient safety. Antibiotic stewardship, care coordination, and keeping track
of the latest finding, are also suggested. In addition, showing appreciation for the departments
following the protocols in the prevention program, and unit-based champions programs will help
the organizations with the prevention of infections and patients safety (Kemmerly, 2009).
Programs that prevent nosocomial transmissions from healthcare workers to patients provide
important cost savings for the institution and the health care insurer. The cost calculation for the
program should include the expense of purchasing a new product, personnel time for education,
and costs for implementation or using the device (Barnette, et al, 1999). According to the panel,
there are eight categories for a healthy and effective hospital-based infection control and
epidemiology program. First, they suggest the management of critical data and information.

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Second, setting and recommending policies and procedures. Compliance with regulations,
guidelines and accreditation requirements are also suggested. Furthermore, employee health;
direct intervention to prevent transmission of infectious diseases; education and training of
healthcare workers; personnel resources; and nonpersonnel resources are also considered.
According to the Budget Request Summary-Fiscal Year 2015, the president’s request for
CDC is $6.6 billion, a decrease of $246 million from FY 2014 enacted. The requested amount
includes $5.4 billion in budget authority, $810 million from the prevention and Public Health
Fund (PPHF), and $397 million from Public Health Services (PHS) evaluation funds.
The Morbidity and Mortality Weekly Report (MMWR, 1990-1999) states that the
Nosocomial Infections Surveillance (NNIS) is a voluntary, hospital-based reporting system to
monitor hospital-acquired infections to guide the prevention efforts of Infection Control
Practitioners (ICPs).
Nosocomial infections claim the lives of 100,000 patients each year in the US. The US
spends billions of dollars for the treatment of hospital-acquired infections. But disease control
programs are effective only if they are comprehensive and include surveillance and prevention
activities as well as staff training. Also, hospitals must provide sufficient funds to support these
programs. The implementation of programs for the prevention, transmission, and resistance of
infections would work only if the health care workers develop a hand-hygiene culture in the
organization. Hence, hands-washing is a simple and effective way to prevent illness, hand
hygiene is the most important intervention to reduce the risk of nosocomial infections.

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References
Barnette M., et al. (1999, October 20). Requirements for infrastructure and essential activities of
infection control and epidemiology in out-of-hospital settings: a consensus panel report.
Association for Professionals in Infection Control and Epidemiology and Society for
Healthcare Epidemiology of America. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/10530650
(2014). Budget request summary-Fiscal Year 2015. Centers for Disease Control and Prevention.
Department of Health & Human Services. Retrieved from www.cdc.gov/budget
Kemmerly, S. A., & Reed, D. (2009, Spring). Infection control and prevention: A review of
hospital-acquired infections and the economic implications. Department of Infection
Control. Retrieved from http://www.nbci.nlm.nih.gov/pmc/aricles/PMC3096239/
MacDonald, I. (2013). Hospitals get tough with hand-washing offenders. Fierce Healthcare.
Retrieve from http://www.fiercehealthcare.com/story/hospitals-get-tough-hand-
washing-offenders/2013-05-29
Mangiadi, J. R., & Marcovici, R. (2011). History of hospital acquired infections. Optimus.
Retrieved from http://optimusise.com/history-hospitas-infection.php
(2000, March 03). Monitoring hospital-acquired infections to promote patient safety – United
States, 1990-1999. Centers for Disease Control. Morbidity and Mortality Weekly
Report. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4908al.htm
Vaidya, A. (2013). 10 Best strategies for infection prevention and control. Beckers Hospital

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Review. Retrieved from http://www.beckershospitalreview.com/quality/10-best-
strategies-for-infection-prevention-and-control.html

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