Preventing Hospital Infections
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Preface
Healthcare-associated infections remain one of the most persistent and consequential challenges facing modern healthcare systems. Each year in the United States alone, millions of patients acquire infections during the course of receiving care, and tens of thousands lose their lives as a result. What makes this burden especially trouble is that many of these infections are not inevitable. A substantial body of evidence demonstrates that well-established preventive practices can dramatically reduce infection rates, saving lives while also lowering costs. Yet the consistent and sustained application of these practices continues to fall short of what is possible.
The gap between evidence and everyday practice does not stem from a lack of scientific knowledge or technological solutions. Rather, it reflects the difficulty of translating proven methods into routine behavior within complex healthcare organizations. While existing literature on healthcare-associated infections is extensive, it largely emphasizes clinical classifications, microbiology, and technical interventions. Comparatively little attention has been paid to the human, organizational, and cultural factors that ultimately determine whether prevention strategies succeed or fail.
This book is written to address that imbalance. Its primary focus is not on what should be done to prevent infection, but on how prevention efforts can be effectively implemented and sustained in real-world hospital settings. The chapters offer practical insights into the challenges of change, highlighting the roles of leadership, frontline clinicians, and interdisciplinary teams in shaping successful quality improvement initiatives.
The narrative follows the course of a representative hospital-based intervention, tracing its development from the initial leadership decision to pursue change, through the selection of project leaders and clinical champions, to pilot testing, system-wide implementation, and long-term maintenance of gains. Particular attention is given to understanding resistance to change, fostering engagement among healthcare personnel, and creating environments in which evidence-based practices can take root and endure.
Although the central example used throughout the book focuses on the prevention of catheter-associated urinary tract infections, the principles and lessons extend well beyond this single condition. Because such infections involve multiple disciplines and affect patients across hospital units, they provide a useful lens through which to examine broader issues in quality improvement. Readers will find that the strategies discussed are readily applicable to other patient safety priorities, including the prevention of blood clots, pressure injuries, and inpatient falls.
The book is intentionally concise and written in an accessible, conversational style. Its content reflects more than a decade of research, fieldwork, and collaboration aimed at understanding why some hospitals consistently achieve better outcomes than others. This work has been shaped by partnerships with healthcare professionals, administrators, and researchers, as well as by the experiences of those working on the front lines of patient care.
Ultimately, this book is intended for all who are engaged in the effort to make healthcare safer—clinicians, leaders, quality improvement professionals, and policymakers alike. By focusing on the human side of change, it seeks to provide practical guidance for turning knowledge into action and for ensuring that preventable harm is, in fact, prevented.
