Reducing Nosocomial Infections: A Healthcare Policy Brief

Introduction: The Problem of Healthcare-Acquired Infections

From the outset, it is important to note that nosocomial, or healthcare-acquired infections (HAIs), are quite common in healthcare settings. In basic terms, nosocomial infections can be defined as all those infections that are acquired or contracted within the healthcare environment. More specifically, the World Health Organization (WHO, 2020) defines these infections as all those that "affect patients in a hospital or other health-care facility, and are not present or incubating at the time of admission." According to WHO (2020), this category of infections may also include infections acquired by hospital staff in the course of executing their duties within a healthcare facility. This is the definition adopted in this policy brief.

As the Centers for Disease Control and Prevention (CDC, 2018) observes, at least 1 out of every 31 hospitals across the country reports a minimum of one nosocomial infection on a daily basis. The impact this has on the general wellbeing of patients and hospital staff is significant. Indeed, according to WHO (2020), "hundreds of millions of patients are affected by health care-associated infections worldwide each year, leading to significant mortality and financial losses for health systems." Given this reality, the importance of proposing policy measures to help address this problem cannot be overstated.

Background: Existing Laws and Their Limitations

The CDC (2018) points out that although some progress has been made in efforts to reduce HAIs, there is still a great deal of work to be done. This view is echoed by Stone et al. (2015), who note that although there are numerous laws — both federal and state — that have been enacted in an attempt to curtail HAIs in healthcare institutions, significant progress is yet to be made. Some of the laws enacted on this front relate to the public reporting of nosocomial infections. For instance, a total of 37 states have specific laws requiring healthcare institutions to furnish the National Healthcare Safety Network (NHSN) with relevant HAI data on a regular basis (CDC, 2020). At the federal level, it is worth noting that, as per Public Law 111–148, Medicare is permitted to make payments to healthcare institutions on the basis of their reporting of quality measures (Stone et al., 2015).

However, as Stone et al. (2015) observe, "the federal laws apply across all 50 states and provide incentives only; these interventions do not mandate action" (p. 639). It is on this basis that this brief proposes the formulation of standard preventive measures to be applied uniformly across healthcare institutions in an effort to reduce nosocomial infections.

Proposed Law: Mandatory Preventive Measures

The suggested law would establish specific organizational and administrative measures that each healthcare institution would be required to adhere to in order to minimize instances of nosocomial infections. Two such measures are proposed:

1. Hospitals to ensure that all staff receive the recommended viral and bacterial vaccines. This is particularly important given that recent studies have found that "historic and current vaccines have already contributed to reductions in healthcare-associated infections, and future vaccines have the potential to reduce these infections further" (McIntosh, 2018, p. 20). Mandating staff vaccination would therefore serve as a direct and evidence-based mechanism for reducing HAI transmission within healthcare facilities.

2. Hospitals to maintain formal education and training programs for staff on the prevention of nosocomial infections. This would ensure that both new and existing staff possess the relevant skills and knowledge to prevent HAIs in the hospital environment, thereby helping to bring down the overall rate of nosocomial infections. The CDC provides prevention tools and guidance that could serve as a foundation for developing such training curricula.