Evaluating the efficacy of nursing interventions in reducing infection rates among emergency department patients.

BACKGROUND

Healthcare-associated infections (HAIs) are a significant concern in emergency departments (EDs), where high patient volumes, rapid decision-making, and frequent invasive procedures increase infection risks. Despite existing infection prevention measures, the effectiveness of nursing interventions in reducing HAIs in ED settings remains underexplored.

OBJECTIVE

This study evaluates the efficacy of nursing interventions in reducing HAIs among ED patients through a systematic review and meta-analysis, identifying the most effective strategies and providing evidence-based recommendations for infection control.

METHODS

A systematic review and meta-analysis were conducted following PRISMA guidelines. A comprehensive search of PubMed, Cochrane Library, Scopus, and Web of Science was performed to identify relevant studies assessing nursing-led interventions for infection prevention in EDs. Eligible studies included randomized controlled trials (RCTs), quasi-experimental studies, and observational research reporting infection rates as primary outcomes. A random-effects model was used to estimate pooled effect sizes, and subgroup analyses explored the relative effectiveness of different intervention types (hygiene protocols, care bundles, patient education, environmental cleaning). Heterogeneity was assessed using I2 statistics, and publication bias was examined using funnel plots and Egger's test.

RESULTS

Ten high-quality studies involving 5,500 patients were included. The pooled odds ratio (OR) for nursing interventions in reducing HAIs was 0.69 (95 % CI: 0.65-0.74, p < 0.001), indicating a 31 % reduction in infection odds. Hygiene protocols demonstrated the greatest efficacy (OR = 0.62, 95 % CI: 0.57-0.68, p < 0.001), followed by care bundles (OR = 0.68, 95 % CI: 0.61-0.75, p < 0.001) and environmental cleaning (OR = 0.75, 95 % CI: 0.68-0.82, p < 0.001). Heterogeneity was moderate (I2 = 40 %), with higher variability in care bundles and environmental cleaning interventions. Sensitivity analyses confirmed the robustness of findings, and publication bias was minimal (Egger's test, p = 0.18).

CONCLUSION

Nursing interventions significantly reduce HAIs in EDs, with hygiene protocols and care bundles being the most effective. Standardizing infection prevention protocols, integrating evidence-based nursing interventions, and ensuring adherence to best practices can enhance patient safety. Future research should explore the long-term sustainability of these interventions, the impact of multifaceted approaches, and their effectiveness across diverse patient populations.