Infection Prevention in the Emergency Department

Abstract

Infection prevention remains a major challenge in emergency care. Acutely ill and injured patients seeking evaluation and treatment in the emergency department (ED) not only have the potential to spread communicable infectious diseases to healthcare personnel and other patients, but are vulnerable to acquiring new infections associated with the care they receive. This article will evaluate these risks and review the existing literature for infection prevention practices in the ED, ranging from hand hygiene, standard and transmission-based precautions, healthcare personnel vaccination, and environmental controls to strategies for preventing healthcare-associated infections. We will conclude by examining what can be done to optimize infection prevention in the ED and identify gaps in knowledge where further research is needed. Successful implementation of evidence-based practices coupled with innovation of novel approaches and technologies tailored specifically to the complex and dynamic environment of the ED are the keys to raising the standard for infection prevention and patient safety in emergency care.

Tuberculosis infection via the emergency department among inpatients in South Korea: a propensity score matched analysis of the National Inpatient Sample

“…In healthcare settings, TB is transmitted from person to person, specifically when droplet nuclei generated by patients with infectious TB are inhaled by another person [4]. Emergency departments (EDs) are high-risk areas for disease transmission [6,7], and are associated with TB outbreaks [8e11]. Given that EDs are often overcrowded and patients with undifferentiated illnesses remain in EDs for a long time, possibly in close proximity to each other [6,7], acutely ill or injured patients who visit EDs may be particularly vulnerable to TB infection.…”

Hand Hygiene Compliance in the Setting of Trauma Resuscitation

“…1,24 The University of Maryland's R. Adams Cowley Shock Trauma Center offers a unique opportunity to study HH compliance in this context where existing video surveillance infrastructure allows for unbiased viewing of healthcare worker (HCW) behavior. We aimed to quantify opportunities for HH according to WHO guidelines and to measure HH compliance and glove use during active resuscitation of trauma patients in the center's Trauma Resuscitation Unit (TRU).…”

Emergency Department Catheter-Associated Urinary Tract Infection Prevention: Multisite Qualitative Study of Perceived Risks and Implemented Strategies

“…8 We sought to study positive deviants, ie, early-adopting EDs that were leading the way toward preventing CAUTI and that could serve as models for other EDs with less advanced practices. We defined earlyadopting EDs as those having core attributes of ED CAUTI prevention programs, 6,[9][10][11][12][13] specifically, those using criteria for urinary catheter placement and monitoring the frequency of ED-placed catheters. We identified these EDs by reviewing results from a nationwide survey in which EDs reported their adoption of infection prevention best practices 14 and by contacting national professional organizations, (eg, the Emergency Nurses Association and the American College of Emergency Physicians).…”