Emergency departments (EDs) accounted for 12% of all ambulatory visits and 43% of hospital admissions nationwide in 2006. Human factors such as the environment, workflow and culture make the ED an ideal setting for the transmission of hospital acquired infections (HAIs). ED patients are a diverse mix of the chronically ill and the healthy, the immunosuppressed and the immunocompromised, the young and the old, and the rich and the poor.
For many inpatients, the ED is the location where central venous and urinary catheters are first placed; for outpatients, the ED is their only contact with the hospital environment’s unique microbial flora. Yet, emergency medicine culture, focused on acute time-sensitive conditions, deemphasizes downstream consequences such as HAIs.
Recent initiatives, based on implementation of evidence-based best practices, have been shown to reduce HAIs. These initiatives were developed in the hospital inpatient environment, particularly inintensive care units (ICUs). To date, there has been little published regarding the adoption of currently recommended HAI prevention strategies in U.S. EDs.