Nosocomial infection according to the National Nosocomial Infections Surveillance (NNIS) is a hospital-acquired infection, either localized or systemic, caused by a pathogen or toxin that was not present (or incubating) in the patient at the time he/she was initially hospitalized. In some cases, infections occur within 24-48 hours, but other infections may not become evident until after discharge from the hospital because incubation times and resistance varies. An infection that occurs after discharge but is hospital-acquired is still considered nosocomial

Nosocomial infections are a grave cause of concern, especially with the marked increased in methicillin-resistant staphylococcus aureus (MRSA) infections. Hospital-acquired infections are frequently related to surgical sites, invasive devices, such as urinary and central line catheters and mechanical ventilators. Studies indicate that proper handwashing techniques and consistent handwashing before and after caring for each patient can effectively reduce infection rates.

Preventing nosocomial infections

Follow protocols for use of mechanical ventilators. Avoid or limit the use of urinary Foley catheters.

Examine all central and peripheral lines for indications of infection at least every 8 hours and follow all protocols for safety.

Examine surgical sites for indications of infection at least every 8 hours, using aseptic technique for all wound care.

Utilize proper hand washing technique under running water if there is any debris on the hands:

• Wash hands under running water with plain soap rather than antimicrobial soap because of issues related to resistance.

• Lather hands thoroughly, covering all areas of the hands and

wrists with soap, and then rinsed.

• Avoid contacting surfaces that might serve as vectors, such as faucet handles and doorknobs, after washing hands

• Turn the faucet off by using the elbow or upper forearm or holding a piece of paper towel as a barrier.

• Dry the hands with disposable towels.

Utilize alcohol based rubs, such as Purell®, to kill bacteria on the hands if they are not contaminated or do not contain debris:

• Rub alcohol cleaner on hands, coating all hand surfaces, including between the fingers, the wrists, and under the nails, and then continuing rubbing the hands together until the solution evaporates, at least 15 second

Do not rinse hands.