Emergency Departments (EDs) are an ideal setting for transmission of healthcare associated infections (HAI), yet little attention has been paid to infection prevention in U.S. EDs. There are approximately 5000 EDs in the U.S., and patients make approximately 136 million visits annually. Patient populations are diverse, including the chronically ill and the previously healthy, the rich and the poor, the young and the old, the immunocompetent and the immunosuppressed. Healthcare workers in the ED have varied levels of training, yet share a concern for immediate patient care needs, and a common environment that is crowded, interruption filled and chaotic. Questions such as whether and how to place central lines and urinary catheters and when to perform hand hygiene may seem less important than the immediate needs of multiple sick patients. EDs operate within a culture that prioritizes urgent intervention over prevention, that values decisive action over precautions and circumspection, and that has """"""""normalized deviancy"""""""" in response to chronic crowding and chaos. In addition, EDs have been shown to have a unique set of human factors concerns compared to other settings and these factors directly affects the use of infection control practices. Therefore there is a need to further explore infection prevention practices in EDs. We propose a Conference with the following aims: 1. To identify barriers to infection control in EDs, focusing on the human cultural, organizational and environmental characteristics;2. To identify potential strategies for knowledge translation of proven infection prevention practices into EDs, focusing on sustainable solutions;3. To develop a research, quality improvement action and education agenda for infection prevention in emergency care. Prior to the conference, a steering committee including leaders from emergency care (physicians, nursing, EMS), infection prevention, patient safety and human factors engineering will meet to develop work plans for the conference aims. The conference will be held in parallel with the American College of Emergency Physicians annual Scientific Assembly, the largest meeting of emergency physicians in the world. Following the conference, concept papers detailing the conference recommendations will be issued to AHRQ and submitted to a peer-review journal to help design and prioritize research funding programs, quality improvement interventions and educational curricula that will ultimately improve patient care in this country. We propose a national research development and dissemination conference to explore infection prevention practices in EDs.

Public Health Relevance

Emergency Departments (EDs) are an ideal setting for transmission of healthcare associated infections (HAI), yet little attention has been paid to infection prevention in US EDs. We propose a conference to bring together leaders in infection prevention, emergency care, human and environmental work systems, and quality improvement to address the unique issues of implementing infection prevention strategies in emergency care. The conference will identify unique barriers to infection prevention in the ED, raise awareness and spread knowledge about best practices, and develop a research, improvement and education agenda for infection prevention and emergency care.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Conference (R13)
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Special Emphasis Panel (ZHS1-HSR-T (03))
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Hall, Kendall
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Brigham and Women's Hospital
United States
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Yanagizawa-Drott, Lisa; Kurland, Lisa; Schuur, Jeremiah D (2015) Infection prevention practices in Swedish emergency departments: results from a cross-sectional survey. Eur J Emerg Med 22:338-42
Liang, Stephen Y; Theodoro, Daniel L; Schuur, Jeremiah D et al. (2014) Infection prevention in the emergency department. Ann Emerg Med 64:299-313
Pallin, Daniel J; Camargo Jr, Carlos A; Yokoe, Deborah S et al. (2014) Variability of contact precaution policies in US emergency departments. Infect Control Hosp Epidemiol 35:310-2