Are healthcare-associated infections on the rise in 2023?

There’s still a lot of work to be done to reduce the impact of healthcare-associated infections (HAIs). It’s already 2023 and we may think that with improved technology and IPC practices, the rate of HAIs is going down. 

A few weeks back, the U.S. Centers for Disease Control and Prevention (CDC) released HAI data. The data doesn’t look optimistic: it seems that HAIs are on the rise. 

More specifically, the 2021 National and State Healthcare-Associated Infections Progress Report shows: 

  • 7% increase in central line-associated bloodstream infections (CLABSIs)
  • 5% increase in catheter-associated urinary tract infections (CAUTIs)
  • 12% increase in ventilator-associated events (VAEs,) or respiratory infections related to the use of mechanical ventilation
  • 14% increase in hospital-onset Methicillin resistant staph aureus (MRSA) bacteremia 

Only hospital-onset Clostridioides difficile infections had a statistically significant reduction (3%) from 2020 to 2021.

Prior to 2020, there had been a decline in HAI rates in US hospitals, which has been linked to better IPC practices. These efforts, however, were undoubtedly hampered by the COVID-19 patient influx in 2020 and the hospital staff and resources that were diverted to care for those patients.

As stated in the report, the rise in HAIs during the pandemic shows how important it is for hospitals to have devoted personnel, budgets, and effective strategies that can keep up IPC even in the midst of a pandemic.

Although in many places hand hygiene levels increased early in the COVID-19 pandemic, they eventually started to fall as the pandemic progressed and a labor shortage became apparent. This signifies that even though high compliance is possible, it is especially challenging to sustain.

Insufficient hand hygiene remains one of the most significant barriers to preventing HAIs. 

Although we have known about the link between hand hygiene and infections since the 1800s and it is a well-known fact that appropriate hand hygiene can prevent up to 50% of avoidable hospital-acquired infections, hand hygiene levels are still suboptimal. 

According to WHO:

  • 1 in 3 facilities lacks hand hygiene facilities at the point of care
  • 8.9 million HAIs occur every year in acute and long-term care facilities in the European Union and European Economic Area (EU/EEA)


Levels of hand hygiene compliance in high-income countries rarely exceed 50% and HAIs in the EU hospitals have, on average, direct medical costs of €7 billion each year.

The World Health Organization has advocated for increased use of electronic hand hygiene monitoring systems (EHHMS) in hospitals, provided that the systems incorporate the WHO Five Moments for hand hygiene indications. Moreover, several studies have demonstrated that management focus and continuous improvement initiatives appear to be critical in assuring adherence to hand hygiene guidelines.

Sani Nudge is the only solution that offers effective improvement and engagement tools based on nudging theory and behavioral science, ensuring sustained hand hygiene performance and reducing hospital-acquired infections. In addition,  Sani Nudge measures hand hygiene levels according to the WHO’s guidelines (moments 1, 4 and 5), is LeapFrog compliant, and can be adapted to local hand hygiene guidelines when needed.

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A true hand hygiene horror story

At times when I talk with hospitals about the importance of healthcare workers performing hand hygiene I am asked:  “Yes, you can significantly improve hand

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