Nosocomial

Definition

Nosocomial (healthcare-acquired) infections (HAIs) are infections that develop during or after a hospital or healthcare facility stay, not present or incubating at admission. They occur greater than 48 hours after admission.

Common HAIs

• Catheter-associated UTI (CAUTI)
• Central line-associated bloodstream infection (CLABSI)
• Ventilator-associated pneumonia (VAP)
• Surgical site infection (SSI)
• C. difficile colitis
• MRSA

Prevention Bundles

• Hand hygiene (#1 measure)
• CAUTI: limit catheter days, aseptic insertion, closed system
• CLABSI: hand hygiene, chlorhexidine skin prep, full barrier precautions, daily line necessity assessment, optimal site selection
• VAP: HOB 30°, daily sedation vacation, chlorhexidine oral care, DVT/stress ulcer prophylaxis
• SSI: preoperative antibiotics, glucose control, shaving with clippers not razors

NCLEX Relevance

Hand hygiene is the single most effective infection prevention measure.