Preventing Hospital Infections: Real-World Problems, Realistic Solutions / Oxford University Press
SANJAY SAINT
SARAH L. KREIN
WITH
ROBERT W. STOCK
preface
Each year, healthcare-associated infections affect millions of patients in the United States, leading to significant illness, loss of life, and increased healthcare costs. While these infections represent a serious public health concern, research has consistently shown that many of them can be prevented. Hospitals that apply proven, evidence-based prevention strategies have the potential to save thousands of lives and reduce unnecessary financial burden. Despite this, a major challenge persists: the gap between knowing what should be done and ensuring that it is consistently carried out in daily clinical practice.
The primary obstacle is not a lack of scientific knowledge or technological solutions, but rather the difficulty of changing human behavior within complex healthcare systems. Many healthcare workers struggle to consistently adopt preventive practices, even when those practices are well supported by evidence. This human and organizational challenge remains one of the most significant barriers to effective infection prevention.
Although the literature on healthcare-associated infections is extensive, most existing resources emphasize the clinical and technical aspects of prevention. They focus on identifying infection types, improving hygiene standards, or introducing new devices and protocols. Comparatively little attention is paid to how healthcare professionals perceive, accept, and sustain these preventive measures in real-world settings.
This book addresses that gap by focusing on the behavioral, cultural, and leadership factors that influence infection prevention efforts. It provides practical guidance on managing hospital-based quality improvement initiatives, beginning with leadership commitment and extending through team formation, pilot implementation, hospital-wide adoption, and long-term sustainability. The book also explores common sources of resistance to change and offers strategies to overcome them, while highlighting the critical role of leadership in driving successful improvement initiatives.
The structure of the book follows a realistic infection prevention initiative as it might unfold in a hospital setting. Although the primary example centers on the prevention of catheter-associated urinary tract infections (CAUTI), the lessons presented are broadly applicable across departments and clinical roles. As a result, the principles outlined can be applied to a wide range of quality improvement efforts, including the prevention of pressure injuries, venous thromboembolism, and patient falls.
Written in a clear and engaging style, the book draws on more than a decade of research and hands-on experience in infection prevention and healthcare quality improvement. This work has been informed by large-scale initiatives and collaborative efforts aimed at understanding why some hospitals succeed in reducing infections while others struggle.
The insights presented are shaped by collaboration with healthcare professionals, researchers, and administrators who are deeply committed to patient safety. Their experiences—both successes and challenges—form the foundation of the practical guidance offered throughout the book.
Ultimately, this book is intended for healthcare leaders, clinicians, and improvement teams who are working to reduce infections and enhance patient safety. By addressing both technical solutions and the human factors that determine their success, it offers a comprehensive roadmap for achieving meaningful and sustainable improvement in hospital care.
