Healthcare-associated infections (HAIs), also known as nosocomial infections, are those infections acquired in the hospital or other health care facility (HCF). They affect more than 2 million patients annually (Table 101.1). Adverse consequences of these infections are formidable, resulting in an estimated 900 000 deaths and an overall cost of about $4.5 billion annually in the United States. Since the 1999 report from the Institute of Medicine, To Err Is Human: Building a Safer Health System, reports from several other groups have led to heightened attention to the development of safer health care environments. Leading regulatory, accreditation, and quality-monitoring organizations, including the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), have targeted some HAIs as preventable adverse events and an issue of patient safety. Increased public awareness of the cost and seriousness of HAIs has led to the promotion of public disclosure of HAI rates and motivated several states to develop legislation mandating disclosure of HAIs by hospitals and other health care organizations.

To address the growing concerns, cost, and adverse impact of these infections, HCFs must focus on minimizing the risk of acquiring HAIs within the health care environment. Preventive efforts are especially important in the integrated health care systems that characterize many areas of the United States. In January of 2005, the Institute for Healthcare Improvement (IHI) launched the 100 000 Lives Campaign to target preventable health care-associated errors and deaths.