Reference — Infection Control
Healthcare-Associated Infections Reference
Quick reference for the four major preventable HAIs — CAUTI, CLABSI, VAP, and SSI. Prevention bundles, risk factors, and nursing priorities consolidated for rapid review.
Educational use only. Based on CDC, NHSN, AHRQ, and IHI evidence-based HAI prevention guidelines. Implement prevention bundles per current facility protocol and unit-specific policy. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
HAI Overview
| HAI | Device | Setting | Incidence | Top Priority |
|---|---|---|---|---|
| CAUTI | Urinary catheter | All inpatient | Most common HAI (~30–40%) | Daily necessity review; prompt removal |
| CLABSI | Central venous catheter | ICU, oncology | 12–25% mortality | Scrub the hub; daily line necessity |
| VAP | Mechanical ventilator (ETT) | ICU | 9–27% of ventilated patients | HOB 30–45°; daily SAT/SBT |
| SSI | Surgical incision (no device) | Surgical, perioperative | ~20% of all HAIs | Antibiotics ≤60 min pre-incision |
CAUTI — Catheter-Associated Urinary Tract Infection
Risk Factors
Female sexCatheter > 6 daysDiabetes mellitusBreaks in closed systemImmunocompromiseUrinary obstructionImproper catheter care
Prevention Bundle
| Indication | Insert catheter only when medically necessary — explore alternatives (condom catheter, intermittent cath, incontinence pads) |
| Insertion | Sterile technique always; insert by trained personnel |
| Maintenance | Closed drainage system; bag below bladder; never on floor; secure catheter to prevent traction |
| Daily review | Assess catheter necessity every day; remove when no longer clinically indicated |
| Hygiene | Perineal care with soap and water; avoid antiseptic cleansers at meatus |
| Documentation | Document indication, date of insertion, and daily necessity assessment |
CLABSI — Central Line-Associated Bloodstream Infection
Risk Factors
Femoral siteLong durationTPN infusionImmunocompromiseMultiple lumensFrequent accessPoor insertion technique
Prevention Bundle
| Hand hygiene | Before any line access — no exceptions |
| Maximal sterile barrier | Cap, mask, sterile gown, sterile gloves, large sterile drape during insertion |
| Skin prep | Chlorhexidine-alcohol — allow to fully dry before insertion |
| Site selection | Subclavian > internal jugular > femoral — avoid femoral when possible |
| Hub care | Scrub the hub ≥15 seconds with chlorhexidine or 70% alcohol before every access |
| Dressing | Chlorhexidine-impregnated transparent dressing; change per protocol (every 7 days or when soiled/lifting) |
| Daily review | Assess line necessity daily; remove when no longer needed |
VAP — Ventilator-Associated Pneumonia
Risk Factors
Supine positionProlonged ventilationReintubationNG tubeSedationPrior antibioticsImmunocompromisePoor oral hygiene
Prevention Bundle
| HOB elevation | 30–45° continuously — measure with angle tool, not visual estimate; highest-impact intervention |
| Oral care | Daily oral care with regular toothbrushing — routine chlorhexidine is no longer recommended (2022 SHEA/IDSA Compendium; possible excess mortality, no clear VAP benefit) |
| SAT | Daily Spontaneous Awakening Trial (SAT) — interrupt sedation and assess readiness to extubate |
| SBT | Daily Spontaneous Breathing Trial (SBT) paired with SAT — assess for extubation readiness |
| Cuff pressure | Maintain ETT cuff pressure 20–30 cmH₂O — prevents aspiration past cuff |
| Subglottic drainage | Use ETT with subglottic suction port; drain secretions every 2–4 hours |
| Circuit changes | Do not change routinely — change when visibly soiled or malfunctioning |
| Mobilization | Passive ROM and early progressive mobility when clinically appropriate |
SSI — Surgical Site Infection
Risk Factors
ObesityDiabetesSmokingImmunosuppressionLong procedureEmergency surgeryRemote infection at time of surgeryHypothermia
Prevention Bundle
| Antibiotics | Administer ≤60 minutes before incision; re-dose for procedures > 4 hours |
| Hair removal | Use clippers (not razors) immediately before procedure if needed |
| Skin prep | Chlorhexidine-alcohol — allow to dry fully before draping |
| Normothermia | Active warming preoperatively and intraoperatively; maintain ≥36°C |
| Glycemic control | Target BG < 180 mg/dL perioperatively; avoid hypoglycemia |
| Wound assessment | Each dressing change: assess color, drainage, odor, approximation, edema |
| Patient education | Smoking cessation, glycemic control, wound monitoring, when to call provider |
NCLEX Pearls
- ✦CAUTI: daily necessity review and prompt catheter removal is the #1 prevention strategy.
- ✦CLABSI: scrub the hub ≥15 seconds before every central line access — no exceptions.
- ✦VAP: HOB elevation 30–45° must be continuous — verify with an angle-measuring tool.
- ✦SSI: prophylactic antibiotics within 60 minutes before incision, not before the patient arrives or after the incision is made.
- ✦Perioperative hyperglycemia (>180 mg/dL) is a modifiable SSI risk factor.
- ✦HAI prevention is a nursing accountability issue — daily device necessity assessment is a nursing-driven intervention.
Related Resources
Healthcare-Associated Infections GuideFull guide with CAUTI, CLABSI, VAP, SSI — clinical detail and nursing rationale
Open →Infection Prevention Bundles ChartBundle elements and nursing priorities for each HAI type
Open →Standard PrecautionsHand hygiene, PPE, and the foundation of HAI prevention
Open →Mechanical Ventilation BasicsVentilator management and VAP prevention in context
Open →Standards & sources
Fact-checked Jun 21, 2026This page is written to align with CDC / HICPAC · Infectious Diseases Society of America (IDSA) / SHEA. It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →