Effectiveness of nursing interventions on preventing the risk of infection in hospitalized adults: a systematic review

Healthcare-associated infections (HAIs) remain a global challenge for patient safety and quality of care, affecting millions of individuals each year and resulting in substantial morbidity, mortality, and financial burden. In Europe alone, over 4.2 million episodes of HAI occur annually. Nurses play a pivotal role in infection prevention through the implementation of evidence-based interventions aimed at disrupting transmission chains and reducing infection risk. Despite the widespread dissemination of preventive strategies, marked heterogeneity persists in their implementation and effectiveness, influenced by institutional, behavioural, and contextual factors. To critically evaluate the effectiveness of nursing interventions in preventing infection risk among hospitalised adults through a systematic review of the literature. A systematic review of Randomised Controlled Trials (RCTs) was conducted following the Joanna Briggs Institute (JBI) methodology and PRISMA 2020 guidelines, with prior registration in PROSPERO (CRD42024582820). Searches were performed across MEDLINE, CINAHL, Scopus, Web of Science, and the Cochrane Library up to January 2025. Methodological quality was assessed using JBI critical appraisal tools, and the certainty of the evidence was rated using the GRADE approach. Given the heterogeneity of the included studies, a narrative synthesis was undertaken. Out of 8,123 records identified, 22 RCTs (1979–2024) met the inclusion criteria. Nursing interventions, including daily body bathing with chlorhexidine, prevention bundles for catheters and other devices, promotion of hand hygiene, educational strategies, and environmental disinfection (e.g. ultraviolet-C light) demonstrated a significant reduction in HAI incidence compared with usual care. Multimodal and integrated interventions proved more effective than isolated measures. The overall certainty of evidence was moderate for infection reduction and adherence improvement, but inconsistent for patient mortality and satisfaction outcomes. Evidence-based nursing interventions, particularly when applied in a coordinated and multimodal manner, substantially reduce infection risk among hospitalised adults. These findings support the integration of such interventions into institutional programmes and infection control policies. Further multicentre RCTs are recommended to assess implementation fidelity, cost-effectiveness, and patient-centred outcomes. Not applicable.