Nicholas: Basic safeguards could prevent hospital infections

New technologies tend to dominate headlines in modern medicine, but infection-control experts warn that basic, overlooked safeguards are increasingly becoming weak links in patient safety — contributing to the stubbornly high rate of hospital-acquired infections (HAIs) in the United States.

According to the Centers for Disease Control and Prevention, one in 31 hospital patients on any given day has at least one HAI. Nearly 1.7 million patients develop these infections annually, and 100,000 die in hospitals as a result. HAIs cost the healthcare system between $28 billion and $45 billion annually, according to research funded by the National Institute of Nursing Research.

Now, infection-control specialists say small, inexpensive interventions — such as routine replacement of cubicle curtains — could dramatically reduce those risks.

High-touch surfaces are expected to be cleaned frequently in clinical settings, but cubicle and privacy curtains often go unnoticed. Infection Control Today recently identified them as among “healthcare’s most touched and least regulated surfaces.”

Most hospitals change curtains only when they appear soiled. However, a study published in the American Journal of Infection Control found privacy curtains can be breeding grounds for resistant bacteria such as MRSA. Most hospitals change curtains when they are visibly soiled, despite evidence that they become contaminated over a 21-day period, with 87.5% of the curtains testing positive for methicillin-resistant Staphylococcus aureus by day 14.

With federal and state guidelines offering little clarity, the publication recommends hospitals replace privacy curtains at least once per quarter and use electronic tracking systems to ensure compliance. Advocates say this low-cost practice could significantly reduce transmission risks in patient rooms.

Another low-cost, highly effective policy is hand hygiene. Despite decades of public health messaging, hand hygiene remains another chronic weak point. One study cited by researchers found a striking disconnect between how often clinicians believed they cleaned their hands and how often they actually did. Operating-room staff self-reported compliance rates of 73%; endoscopy staff reported 95%. Observed compliance was just 11%.

Catheter-associated urinary tract infections (CAUTIs) also remain among the most common HAIs. These, too, are highly preventable.

Nurse-driven protocols allowing nurses to remove catheters without physician orders have shown significant benefits. One study found these protocols reduced catheter use from 49.4% to 34.84% and cut CAUTI incidence by more than half.

While hospitals continue investing in advanced diagnostic tools and antimicrobial materials, infection-prevention experts say the fundamentals still matter most. Simple, inexpensive steps — washing hands, replacing contaminated curtains, removing unnecessary devices — have proven track records of reducing infections, saving lives and lowering costs.

Karina Nicholas is a freelance writer in Michigan/InsideSources

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