This chapter briefly discusses Health Care Associated Infections (HAI), the elements required for infectious agent transmission within a health care setting (chain of infection, sources of infection, susceptible host, mode of transmission, portal of entry and portal of exit), HAI among health-care workers, Universal Precautions (UP), Body Substances Isolation (BSI), and Standard Precautions), as well as HAI among health-care workers (SP).


The Centers for Disease Control and Prevention (CDC) defines health-care associated infection (HAI) as a “infection caused by a wide variety of common and unusual bacteria, fungi, and viruses during the course of receiving medical care,” also known as nosocomial infection and hospital acquired infection (CDC, 2012). It might arise while patients are receiving care or after they have been discharged. It also entails occupational infection among employees. HAI is also described as a “infection arising in patients during the course of care in a hospital or health care facility that was not present or incubating at the time of admission and was not present or incubating at the time of admission.” This includes diseases picked up in the hospital but showing up after discharge, as well as occupational infections among workers or at the facility.”

Every year, HAI infects hundreds of millions of patients worldwide, in both developed and developing countries. According to the WHO, its frequency in industrialized countries ranged from 3.5 percent to 12 percent, whereas it ranged from 5.7 percent to 19.1 percent in underdeveloped countries (WHO, 2012). HAI was more common in acute surgical, orthopedic, and Intensive Care Unit wards (WHO, 2002). In high-income nations, the prevalence rate of ICU-acquired infection was 30%, but it was at least 2-3 times higher in middle and low-income countries (WHO, 2009; WHO, 2012).

At the patient level, the implications of HAI include increased suffering, complications, treatments, and hospitalization times. In Europe, for example, the number of days spent in hospitals has climbed by about 16 million (WHO, 2012). This is considered a risk factor for acquiring HAI in and of itself, and it entails a rise in expenditures (WHO, 2012). Furthermore, it places a greater financial load on countries’ health-care systems. For example, annual financial expenditures in England exceeded 1.3 billion euros, while costs in the United States of America were around 3.5 billion euros, and 7 billion euros across Europe (WHO, 2012; WHO, 2012; Agozzino et al., 2012).


Both patients and health-care personnel can be affected by HAI. Occupational infections among nurses are included. The transmission of blood-borne diseases such as hepatitis B and AIDS by being exposed to injuries caused by contaminated sharp items such as scalpels and broken glass, as well as needle stick, is a serious occupational hazard due to the nature of their jobs (CDC, 2012). While engaging with patients or giving medical treatment, nurses can become infected with HAIs. They may contribute to the transmission of illnesses. Nurses, for example, were crucial in the amplification of the Marburg viral hemorrhagic fever outbreak in Angola (WHO, 2015). The mode of transmission is determined by a number of parameters, including HCW immunity and the amount of blood transmitted after injury (CDC, 2012). According to the World Health Organization, approximately three million HCWs are exposed to percutaneous bloodborne pathogens each year; 2 million were exposed to HBV, 0.9 million to HCV, and 170,000 to HIV. 15,000 HCV, 70,000 HBV, and 500 HIV infections were caused by these sharp injuries. Approximately 90% of these incidents occurred in underdeveloped nations (WHO, 2014). The infectious agent is transferred to nurses primarily by droplets: direct touch with infectious material or contact with inanimate contaminated things. If infection control practices and basic measures are not followed, the chance of infectious agent transmission increases (WHO, 2013).

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