Leadership in Prevention of Healthcare-Associated Infections


Healthcare-associated infections are an actual problem of the medical sphere. Since the population grows, the number of patients demanding hospitalizing also increases, which leads to a more active development of this type of infections. However, a proper organization of work in a team of healthcare professionals can be one of the factors that help to mitigate the consequences of this problem. Leadership and management in nursing and midwifery teams can decrease the number of patients severely suffering from healthcare-associated infections.

The Problem of Healthcare-Associated Infections

Definition of Healthcare-Associated Infections

Healthcare-associated infections occur in a place of care during the period of hospitalization. As Fineschi (2019) puts it, these infections are neither clinically present nor incubated at the time of admission and do not occur after the patient’s discharge. The type of infections that a patient gets in a hospital strongly depends on the specialization of the place of care. Infections caused by bacteria resistant to antibiotics are a serious problem (Giraldi et al., 2019). For example, European Union spends more than 1.5 billion euros due to the productivity loss and health costs which are caused by them (Fineschi, 2019, p. 606). According to Centers for Disease Control and Prevention (2018), every day approximately 3% of patients get a healthcare-associated infection. Although Patti et al. (2020) argue that their number gradually decreases, these infections are still an important problem.

Ways to Prevent Healthcare-Associated Infections

Although healthcare-associated infections are often caused by resistant bacteria, it is still important to monitor patients’ and medical professionals’ hygiene. Cha and Kim (2020) note that hand hygiene is a reliable method of infection prevention, despite the intensive labor. Association for Professionals in Infection Control (2021) describes special programs that are dedicated to the guidance of hand hygiene of nursing and medical professionals. There are certain guidelines that should be met and monitored in each healthcare facility regarding this issue.

Apart from hand hygiene, there are other methods of prevention healthcare-associated infections. Accardi et al. (2019) describe seven main areas in which it is possible to prevent the infections or mitigate their consequences. The first area is disinfection, cleaning, and sterilization of medical facilities. The second one is prevention of urinary tract infections related to catheter usage. Prevention of bacteremia caused by catheter is the third area. Standard and isolation precautions should also be provided in order to fight healthcare-associated infections. Finally, surgical site infections and respiratory tract infections should also be prevented.

The main task of a leader of a team of nursing professionals is to ensure that all areas are addressed and monitored constantly by the personnel. Inspections can be conducted in order to check the level of awareness of the professionals in each of the spheres. For example. Accardi et al. (2019) found that among the nursing personnel, the greatest gap in the knowledge relates to cleaning, sterilization, and infection. More than half of nurses gave answers that showed a low level of hygiene in wards, for example, they wore jewels on their hands and wrists during action. Besides, a handrub device based on alcohol could be accessed very seldom. Thus, there are problems concerning both the discipline of the personnel and the overall organization of the hygiene provision. These problems could be solved by proper management, for example by regular trainings and inspections.

Critical Areas in the Development of Hand Hygiene Programs

Although hand hygiene is a globally applied practice, in different regions its accessibility varies widely. In the poorest countries it can be challenging to ensure the adequate level of hygiene. In this sphere, proper management can be a solution for the number of areas. For example, trainings of infection control among healthcare professionals should be held. A team leader should ensure that the personnel is aware about the importance of hand hygiene and passes the trainings. The leader also should try to provide the appropriate level of infrastructure in the facility. Sometimes it is difficult to achieve, since in the developing countries the conditions do not always allow the professionals and patients to keep the hygiene at the proper level. However, the information about the importance of washing hands should be spread among the patients. A team leader can set a goal to increase the level of the patient safety culture.

Catheter-Associated Urinary Tract Infection Prevention

Catheter-associated infections are one of the main fields of healthcare-associated infections. Landerfelt et al. (2020) have examined the leadership skills and traits that allowed the nursing personnel to decrease the number of catheter-associated diseases in their facilities. First of all, nurses that had developed leadership skills provided a common goal in ensuring the patient care safety. They recommended themselves as good managers able to successfully organize the work in a team. Efficient leaders backed up the stuff in decision making even in case when there was a conflict with a physician. Besides, supervisors used mistakes not as the basis for criticism but as learning opportunity. They also supported the nurses and praised them for good job.

Leadership Skills and Approaches in Nursing

These skills described above can be used for prevention not only of catheter-associated, but of other healthcare-associated infections as well. A range of measures should be taken by nursing leaders in order to ensure the patients’ safety. Caroleo et al. (2019) state that clinical audits should be held in order to investigate the reasons of infection occurrence. A team leader should ensure that the audits are held regularly in order to state the reasons of diseases.

As for the leadership styles that can be acquired by nursing personnel, transformational leadership seems to be one of the most effective ones. Giddens (2017) states that it allows the leaders to stimulate, motivate, and inspire team members. Individualized consideration, idealised influence, intellectual stimulation, and inspirational motivation are the basics of this approach. Transformational leadership allows to increase the quality of care and to organize the teamwork properly by motivating its members.


Healthcare-associated infections still remain a severe problem of all healthcare facilities. Their negative impact on the patients and medical personnel can be mitigated by proper management and leadership. Most part of the healthcare-associated infections are caused by bacteria resistant to antibiotics. The ways of fighting them include such actions as sterilization, hand hygiene, prevention of catheter-related infections, and others. From the management perspective, a number of activities should be done in order to monitor the implementation of these measures. Trainings aimed at increasing the awareness of the personnel concerning the hygiene should be conducted. Inspections of the medical facility’s inventory and of the personnel’s knowledge should be held. Transformational leadership is one of the most efficient approaches in nursing management. It allows to inspire team members and to motivate them to do the activities needed to prevent healthcare-associated infections.

Reference List

Accardi, R., Castaldi, S., Marzullo, A., Ronchi, S., Laquintana, D., & Lusignani, M. (2017) ‘Prevention of healthcare associated infections: a descriptive study’, Annali di igiene : medicina preventiva e di comunita, 29(2), 101–115.

Association for Professionals in Infection Control. Guide to hand hygiene programs for infection control prevention. 

Caroleo, B.; Malandrino, P.; Liberto, A.; Condorelli, D.; Patanè, F.; Maiese, A.; Casella, F.; Geraci, D.; Ricci, P.; Di Mizio G. (2019) Catheter-related bloodstream infections: A root cause analysis in a series of simultaneous Ochrobactrum anthropi infections. Current Pharmaceutical Biotechnologies, 20(8), 609- 614.

Centers for Disease Control and Prevention (2018) Healthcare-associated InfectionsHAI data.

Cha, K. S., & Kim, K. M. (2020) ‘Korean National Healthcare-Associated Infections Surveillance (KONIS): Hand hygiene surveillance’, American journal of infection control, 48(3), 327–329.

Fineschi V. (2019) ‘Healthcare-Associated Infections: Antibiotic Poly-therapies, Antibiotic Prophylaxis and Appropriate Policy for the Risk Management to Fight Adverse Events’, Current pharmaceutical biotechnology, 20(8), 606–608.

Giddens J. (2018) ‘Transformational leadership: What every nursing dean should know. Journal of professional nursing’. Official journal of the American Association of Colleges of Nursing, 34(2), 117–121.

Giraldi, G.; Montesano, M.; Frati, P.; La Russa, R.; Santurro, A.; Scopetti, M., Napoli, C.; Orsi, G.B. (2019) ‘Healthcare-associated infections due to multidrug-resistant organisms: A surveillance study on extra hospital stay and direct costs’, Current Pharmaceutical Biotechnologies., 20(8), 643-652.

Landerfelt, P. E., Lewis, A., Li, Y., & Cimiotti, J. P. (2020) ‘Nursing leadership and the reduction of catheter-associated urinary tract infection’, American journal of infection control, 48(12), 1546–1548.

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