Essential Best Practices for Preventing and Controlling Healthcare-Associated Infections

Abstract

Introduction: Healthcare-associated infections (HAIs) remain a major global threat, affecting hundreds of millions of patients yearly with high morbidity, mortality, and economic costs. Common types include catheter-associated urinary tract infections, surgical site infections, central line-associated bloodstream infections, ventilator-associated pneumonia, and Clostridioides difficile infections. Evidence shows 30–70% of HAIs are preventable through systematic evidence-based practices, which this narrative review synthesizes across foundational principles, device strategies, stewardship, surveillance, and implementation. Literature was searched comprehensively in PubMed, Cochrane Library, Google Scholar, and Web of Science, focusing on 2010–2025 publications, with key earlier works included. Gray literature from WHO, CDC, ECDC, and SHEA supplemented sources. English-language studies on HAI prevention in healthcare settings were selected, covering guidelines, systematic reviews, trials, quality reports, surveillance data, and consensus statements for a broad evidence overview. Hand hygiene via the WHO Five Moments framework reduces HAI rates by 15–50% with consistent adherence. Device bundles for insertion and maintenance cut central line infections, urinary tract infections, and pneumonia by 50–80%, enabling zero rates in high-fidelity programs. Surgical site prevention via preoperative optimization, timely prophylaxis, sterile technique, and wound care lowers rates by 40–70%. Antimicrobial stewardship reduces inappropriate use by 20–35%. Cleaning high-touch surfaces decreases reservoirs by 30–50%, while precautions interrupt transmission. Multimodal strategies tackle barriers at individual (knowledge gaps), environmental (supplies/staffing), and cultural levels. HAIs are largely preventable using hand hygiene, precautions, cleaning, device bundles, surgical strategies, and stewardship. Multimodal approaches with surveillance address implementation barriers through leadership, resources, education, redesign, and safety cultures. Organizations should prioritize these as ethical and economic imperatives, engaging staff for sustained reductions and enhanced patient safety.