It can be overwhelming to continuously prevent HAIs, considering the number of ill and medically compromised people in acute care and long-term care settings. But the everyday routines and practices of healthcare workers determine whether or not pathogens spread. Everyone plays a role.

For healthcare facilities, doing better means finding ways to get closer to achieving “zero harm,” a term that refers to the concept that no patients will be harmed by their interactions with a healthcare system. The Joint Commission says, “Zero harm doesn’t mean zero mistakes.” It does mean:

• Developing systems and processes that reduce the likelihood of mistake
• Creating a safety culture from leaders to frontline workers
• Championing procedures that catch errors or unsafe conditions before they cause harm

“The zones are really a breakthrough,” says Angela Newman, Medline Senior Director of Clinical Services. “They help organizations look at every aspect of infection and ask, ‘How can we improve best practices? What training and education do we need to close gaps? Which products will best support our people and keep everyone safe?’”

So often, infection prevention is thought of in silos: environmental services (EVS) here, clinicians there and materials management elsewhere. But the three zones interconnect and cross over all the time.

“In one interaction with a patient, you’re very likely to touch all three zones,” says Donna Matocha, DNP, Medline Manager of Clinical Resources–Critical Care. “Let’s say, I’m a clinician putting in a central line at the bedside. If the EVS worker didn’t wipe down the bed rail and I put my gloved hand on it and then touch the patient, all three zones had a failure. The zones are always impacting each other.”

“To improve infection prevention metrics, you have to empower and engage everyone,” says Matocha. “The key is to inspire everyone to take ownership and help them understand the vital role they play in preventing HAIs across the organization. Shared accountability is key.”

A patient or resident room and bathroom—or anywhere in the environment of care—provide many places for germs to live. From faucets to floors, bed linens to bed rails, and monitors to medical devices, pathogens are lurking and ready to spread.

Coughs, sneezes, touch. In the human-to-human transmission zone of a healthcare setting, unchecked pathogens can easily cause infection through hand, face and bodily contact. Personal protective equipment (PPE)—such as face masks, air-purifying respirators, gowns and gloves—and hand hygiene products and practices protect patients, residents, family, visitors and staff against germs.

“The number one way to help fight infection is simple: wash your hands,” says Newman. “In fact, hand hygiene is fundamental to all three zones. Everyone coming into the hospital—family members, delivery people and staff—has to practice proper hand hygiene to prevent germ transmission.”

In the clinical practice zone, catheters cause some of the most common HAIs. Central venous catheters (CVCs) and indwelling urinary catheters (IUCs) are access points and breeding grounds for germs that can lead to central line-associated blood stream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs).

Clinicians insert, access and maintain CVCs and IUCs multiple times a day. The way to prevent CLABSI and CAUTI is to standardize care. Having a system of products, such as clinical kits for central line insertion and maintenance, helps clinicians reduce variation and error—and minimize risk of infection.

“Clinical kits, which bundle everything a nurse would need in the right sequence, make it easier for them to do the right thing no matter how busy their floor might be,” says Newman.

Before using an IUC insertion kit, determine if an IUC is necessary. The best way to prevent CAUTI is to avoid using an IUC and instead use external catheters when possible.

Matocha says bundles should be well-engineered from a human factor standpoint.

“If you use the components in sequence, you should be able to do the procedure correctly whether you’re a resident or experienced nurse. That’s a major step toward zero harm,” she adds.