Infection prevention: General principles
- Deverick J Anderson, MD, MPH
Deverick J Anderson, MD, MPH
- Associate Professor of Medicine
- Duke University Medical Center
- N Deborah Friedman, MPH, MBBS, FRACP, MD
N Deborah Friedman, MPH, MBBS, FRACP, MD
- Associate Professor of Medicine, Infectious Diseases Physician
- Barwon Health, Geelong, VIC Australia
Infection prevention and control (hereafter "infection prevention") is grounded in quality improvement techniques and is critical for patient safety [1,2]. Infection prevention programs use protocols and interventions to decrease the risk of infection associated with exposure to healthcare settings.
The field of infection prevention emerged following the study on the efficacy of nosocomial infection control (SENIC), which demonstrated that strategies such as surveillance and feedback led to sizable decreases in hospital-acquired infections . Subsequently, regulatory mandates led to the establishment of formal infection prevention programs, typically supervised by physicians and/or trained nurses and overseen by hospital committees. Increasing hospital regulations, scrutiny from accreditation groups, public reporting of infection-related outcomes, and impact on hospital reimbursement have solidified infection prevention programs as a key component of healthcare activities.
The terminology surrounding infection prevention has evolved over time. Initially, infection control teams sought to reduce "nosocomial" infection. As the focus shifted from monitoring to preventing infection, the teams now prevent "healthcare-associated infection." Similarly, as healthcare delivery has shifted from the hospital to various inpatient and outpatient venues, the term "healthcare epidemiology" has emerged to encompass infection prevention activities in the multiple areas where healthcare is delivered.
In general, infection prevention programs focus on two broad goals: decrease the risk of infection following exposure to healthcare settings (particularly from multidrug-resistant organisms) and decrease the risk of device- and procedure-related infections.
Issues related to general principles of infection control are reviewed here. Interventions to precautions for preventing transmission of infection are reviewed separately. (See "Infection prevention: Precautions for preventing transmission of infection".)
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