One in 38 Is Still One Too Many: Why We Must Remain Relentless in Preventing Healthcare-Associated Infections

The Centers for Disease Control and Prevention (CDC) recently released encouraging new data showing measurable progress in the fight against healthcare-associated infections (HAIs). According to the CDC’s 2023 national HAI prevalence survey, approximately 1 in 38 hospitalized patients had at least one healthcare-associated infection on any given day, compared with 1 in 31 patients in the agency’s previous national survey conducted in 2015. Overall, patients hospitalized in 2023 were 27% less likely to experience an HAI than patients in 2015.

These findings represent an important achievement for healthcare organizations across the United States. They reflect years of investment in infection prevention programs, stronger surveillance systems, evidence-based clinical practices, antimicrobial stewardship, and greater collaboration among infection preventionists, environmental services professionals, clinicians, supply chain leaders, and executive leadership.

The progress deserves recognition. But it does not deserve complacency. Despite these improvements, the CDC estimates that more than half a million healthcare-associated infections still occurred in U.S. acute care hospitals during 2023. Behind every one of these infections is a patient whose hospital stay became longer, more complicated, more expensive, and potentially life-threatening. Many experienced preventable pain, disability, or even death. Families endured unnecessary emotional hardship, while healthcare organizations absorbed substantial financial costs and reputational risk.

From a patient safety perspective, this should not be viewed as a victory lap. Instead, it should serve as a powerful reminder that preventable harm remains far too common. Healthcare has never accepted that medication errors, wrong-site surgeries, or patient falls are inevitable. Likewise, we must reject the notion that healthcare-associated infections are simply an unavoidable consequence of modern medicine. While some infections may occur despite appropriate care, countless HAIs remain preventable through the consistent application of proven infection-prevention practices.

The goal should not simply be “better than before.” The goal must be zero preventable harm. Achieving that vision requires healthcare organizations to remain relentlessly focused on strengthening every component of their infection prevention program, not just during outbreaks or regulatory surveys, but every single day.

The CDC’s Core Infection Prevention and Control Practices provide an excellent roadmap for this work. While individual interventions are important, sustainable success depends upon consistently executing multiple evidence-based strategies simultaneously.

Hand hygiene remains the cornerstone of infection prevention. Despite decades of education, compliance challenges continue across many healthcare settings. Alcohol-based hand rubs, appropriate glove use, leadership accountability, auditing, feedback, and a strong culture of safety remain essential to reducing pathogen transmission.

Environmental cleaning and surface disinfection continue to play a critical role in breaking the chain of infection. High-touch surfaces, shared medical equipment, and patient care environments require standardized cleaning protocols, validated products, competency-based training, and objective monitoring to ensure consistent performance.

Increasingly, healthcare leaders are also recognizing that air quality deserves equal attention. Airborne transmission contributes to the spread of numerous respiratory pathogens, including influenza, RSV, COVID-19, tuberculosis, measles, and other emerging infectious threats. Improving indoor air quality through engineering controls, ventilation optimization, and continuous air disinfection technologies adds another important layer of protection that complements, not replaces, traditional infection prevention practices.

The COVID-19 pandemic fundamentally changed how healthcare organizations think about indoor air. Air should no longer be viewed as simply part of the building infrastructure. It is a patient safety intervention that deserves the same level of strategic planning as environmental hygiene, sterilization, and hand hygiene.

Likewise, skin antisepsis and aseptic technique remain foundational for preventing surgical site infections, central line-associated bloodstream infections, and other invasive procedure-related complications. Every insertion, incision, injection, and dressing change presents an opportunity either to protect the patient or unintentionally introduce microorganisms. Standardization, competency assessment, and adherence to evidence-based protocols remain indispensable.

Healthcare organizations must also continue investing in infection prevention education, competency validation, human factors engineering, and systems-based process improvement. Even the best clinical guidelines are ineffective if they are difficult to follow or inconsistently implemented. Designing workflows that make the right action the easiest action is essential for sustained improvement.

Technology also plays an increasingly important role. Automated monitoring systems, environmental disinfection technologies, continuous air disinfection solutions, electronic surveillance, and data analytics can strengthen traditional infection prevention programs by reducing variability and providing continuous layers of protection. These innovations should not replace frontline infection prevention practices; they should reinforce them.

Perhaps most importantly, infection prevention must remain everyone’s responsibility.
Preventing HAIs is not solely the responsibility of infection preventionists. Success requires active engagement from executive leadership, physicians, nurses, environmental services, facilities management, respiratory therapy, supply chain, biomedical engineering, quality professionals, and frontline staff. Every discipline influences infection risk. Every discipline contributes to patient safety.

The encouraging CDC findings demonstrate that improvement is possible when healthcare organizations commit to evidence-based practices. They also remind us that progress is fragile. Gains can quickly be reversed when attention shifts elsewhere or compliance declines. Healthcare has made meaningful progress over the past decade, and those efforts should be applauded. But no patient enters a hospital hoping to become part of a national statistic. Each individual expects, and deserves, the safest care possible.

The true measure of success is not whether HAI rates are lower than they were eight years ago. The true measure is whether we remain unwilling to accept preventable infections as inevitable. As healthcare continues advancing toward higher reliability, our mindset must remain clear: every preventable infection represents an opportunity to improve. Every missed opportunity is a patient placed at unnecessary risk.

The CDC’s latest data should inspire confidence, but even more importantly, it should renew our commitment to strengthening the fundamentals of infection prevention. By remaining relentlessly focused on hand hygiene, environmental and air disinfection, aseptic technique, skin antisepsis, and continuous quality improvement, healthcare organizations can continue moving closer to the goal that matters most: Zero preventable harm.