What methods reduce the risk of healthcare-associated infections to achieve a high asepsis score?

Methods to Reduce Healthcare-Associated Infections for High Asepsis Score

Hand hygiene and proper use of personal protective equipment are the most fundamental and effective methods to reduce healthcare-associated infections and achieve a high asepsis score. 1

Hand Hygiene

• Decontaminate hands by washing with antimicrobial soap and water or using alcohol-based waterless antiseptic agents when hands are not visibly soiled 1
• Perform hand hygiene before and after contact with patients, especially those with invasive devices 1
• Perform hand hygiene after handling respiratory secretions or objects contaminated with secretions 1
• Decontaminate hands between contacts with different patients and between contacts with a contaminated body site and the respiratory tract 1

Personal Protective Equipment (PPE)

• Wear gloves when handling respiratory secretions or objects contaminated with respiratory secretions 1
• Change gloves between contacts with different patients 1
• Change gloves after handling respiratory secretions before contact with another patient, object, or environmental surface 1
• Wear gowns when soiling with respiratory secretions is anticipated 1
• Change gowns after soiling occurs and before providing care to another patient 1

Aseptic Technique for Procedures

• Perform invasive procedures (e.g., tracheostomy) under strict aseptic conditions 1
• When changing tracheostomy tubes:
  • Wear a gown
  • Use aseptic technique
  • Replace the tube with one that has undergone sterilization or high-level disinfection 1
• For suctioning of respiratory tract secretions:
  • Use sterile, single-use catheters if using open-system suction 1
  • Use only sterile fluid to remove secretions from suction catheters if they will re-enter the patient's lower respiratory tract 1

Equipment Sterilization and Disinfection

• Change the mouthpiece of peak flow meters or the mouthpiece and filter of spirometers between uses on different patients 1
• Avoid using large-volume room-air humidifiers that create aerosols unless they can be sterilized or subjected to high-level disinfection daily 1
• Use only sterile water in humidifiers 1
• Apply chlorhexidine gluconate for oral decontamination to reduce the risk of ventilator-associated pneumonia 2, 3

Environmental Controls

• Maintain a clean surgical environment 4
• Remove faucet aerators in units where immunocompromised patients are treated if Legionella species are detected 1
• Implement selective oral decontamination and selective digestive decontamination to reduce ventilator-associated pneumonia 1

Nursing Interventions

• Practice and promote hand hygiene consistently 1
• Use standard precautions consistently 1
• Ensure proper cleaning and disinfection practices 1
• Remove unnecessary invasive devices promptly 1
• Implement bundle strategies for infection prevention 1
• Place patients in semi-recumbent position (head of bed elevated 30-45°) to prevent ventilator-associated pneumonia 2

Antibiotic Stewardship

• Avoid prolonging antibiotic prophylaxis after surgery, as it is generally not associated with better clinical outcomes 1
• De-escalate to the most appropriate single therapy as soon as the susceptibility profile is known 1
• Administer effective intravenous antibiotics within the first hour of sepsis recognition 2

Patient Education

• Implement educational and training interventions concerning the prevention of surgical site infections 1
• Ensure patients are effectively educated throughout their hospitalization to prepare them for self-care 1

Common Pitfalls and Caveats

• Failure to change gloves between patients is a common breach of aseptic technique 5
• Confusion between "clean," "aseptic," or "sterile" technique can lead to improper practices, especially in home healthcare settings 6
• Lack of competency-based training that doesn't reflect the critical importance of aseptic technique to patient safety 6
• Failure to recognize when aseptic technique has been breached and not taking immediate corrective action 7
• Underestimating the importance of proper hand hygiene as the most fundamental infection prevention measure 1

By implementing these evidence-based practices systematically, healthcare facilities can significantly reduce healthcare-associated infections and achieve high asepsis scores, ultimately improving patient outcomes and reducing morbidity and mortality.