Healthcare organizations take many approaches to prevent healthcare-associated infections, but generally those actions can be categorized into two main camps: vertical or horizontal approaches.
Vertical HAI prevention strategies aim to reduce infection and transmission of specific pathogens, based on active surveillance testing results. On the other hand, horizontal approaches are aimed at reducing the risk of infections from a broad spectrum of pathogens through implementing standardized practices, like improving hand hygiene or environmental cleaning.
An article in Infection Control and Hospital Epidemiology examined each approach to see if one would be more efficient or effective than the other. The authors concluded that a combined approach is likely the most effective method for preventing HAIs. They left the following four recommendations:
1. Use quality improvement methods to ensure reliable implementation of practices known to mitigate transmission of multi-drug resistant organisms and the infections they cause.
2. Adhere to evidence-based strategies for HAI prevention, like hand hygiene routines and adequate environmental cleaning.
3. Apply other horizontal strategies, like universal decolonization, in appropriate settings.
4. Use vertical approaches selectively to control outbreaks or when a new pathogen emerges.
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