Healthcare-associated infections – on developing effective control systems under a renewed healthcare management debate

Purpose The development of control systems to sustain the level of healthcare-associated infections (HAIs) is an emerging issue for healthcare management. This is partly due to the perception that HAI became a serious negative impact factor on the performance of healthcare organizations and on related public health dimensions. Throughout the decade of 1990 a significant number of international programmes were developed to understand and to promote effective HAIs prevention and control systems: Patient Safety and the quality improvement of healthcare organizations became common concepts in healthcare management. However, regardless of advances in infection control systems, the rates of incidence of HAIs remained relatively unchanged in the last decades. The purpose of this study is to point out barriers that recent international literature has identified as factors hindering the successful development of control systems to prevent HAIs. The international debate on possible alternatives to strengthen this common healthcare management issue, benefits form one such update. Methods A literature review was conducted in a 3-month period by two investigators. The BioMed Central, Pubmed, Emerald, and B-on databases were searched for articles published between January 2006 and September 2011. A standard form was created for data extraction. Findings A total of 49 articles met inclusion criteria. Within the analysed articles, 26 were developed in Europe, 15 were developed in North America; 6 were developed in Asia, and 2 in Australia. Thirty (30) different barriers to effective HAIs control systems were identified. The barriers were clustered by dimensions and sub-dimensions. The largest number of barriers clustered, are associated with structures and processes and also barriers associated with healthcare management processes.