EXPLORING THE ROLE OF EVIDENCE-BASED NURSING PRACTICES IN REDUCING HOSPITAL-ACQUIRED INFECTIONS AMONG SURGICAL PATIENTS A SYSTEMATIC REVIEW

Abstract

Background: Hospital-acquired infections (HAIs) remain a significant cause of morbidity and mortality in surgical patients, posing a substantial burden on healthcare systems. Evidence-based nursing practices are fundamental to infection prevention, yet a comprehensive synthesis of their specific impact on HAI rates in surgical units is needed.

Objective: This systematic review aims to analyze the efficacy of evidence-based nursing interventions in reducing the incidence of HAIs among adult surgical patients.

Methods: A systematic review was conducted following PRISMA guidelines. PubMed, Scopus, Web of Science, and the Cochrane Library were searched for randomized controlled trials and prospective cohort studies published between 2014 and 2024. Studies were included if they evaluated a discrete, nurse-led, protocol-driven intervention compared to standard care, with HAI incidence as a primary outcome. Data extraction and risk of bias assessment were performed by two independent reviewers.

Results: Eight studies (n=12,458 patients) were included. The evidence-based nursing interventions, encompassing catheter removal protocols, central line maintenance bundles, and preoperative preparation checklists, were consistently associated with a significant reduction in HAIs. Specifically, they demonstrated pronounced reductions in catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), and surgical site infections (SSIs), with reported risk ratios and odds ratios consistently below 0.7 and high statistical significance (p<0.05).

Conclusion: Protocol-driven, evidence-based nursing interventions are highly effective in reducing HAIs in surgical care settings. These findings underscore the critical role of standardized nursing practices in enhancing patient safety. Future research should focus on standardizing intervention components to allow for meta-analysis and exploring implementation strategies to ensure sustained adherence.