Decontamination strategies in ICU

The recent pandemic has once again highlighted the importance of robust infection prevention strategies in all clinical settings, including ICUs. Anne Savage, a senior staff nurse, and Rachel Crisford, ICU lead nurse, at the Royal Berkshire NHS Foundation Trust, provide an insight into decontamination strategies and discuss the evidence to support best practice.

Nosocomial infections continue to be a significant cause of morbidity, mortality, and added costs in the healthcare setting. Half of all life-threatening nosocomial bloodstream infections and pneumonias occur in intensive care units (ICUs), despite ICUs representing only 15% to 20% of all hospital beds.¹ This means that an efficient focus for prevention and control of life-threatening healthcare-associated infections should be in ICUs. This article examines the potential role of decontamination in ICU as part of an overall infection prevention strategy

Healthcare-associated infections (HCAIs) are described as ‘infections occurring in a healthcare setting that were not present prior to a patient entering that care setting,’.² Estimates of HCAI prevalence vary and the most recent National Institute for Health and Care Excellence (NICE) data estimates a prevalence in hospitals in England of 6.4%.3 However, more recent modelling estimates that, in 2016/2017, in NHS hospitals in England, there could have been 834,000 HCAIs, which potentially cost the NHS £2.7 billion, accounted for 28,500 patient deaths and led to an additional 7.1 million occupied hospital bed days (equivalent to 21% of the annual number of all bed days across all NHS hospitals in England).⁴