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'Zero-tolerance HCAI policies are unrealistic'

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The term “zero-tolerance” has become increasingly popular since its emergence in policing in the 1990s.

Punishments for specific crimes were applied automatically - no mitigating circumstances, no discretion. Use of the term spread into schools and other institutions to outlaw behaviours such as bullying or sexual harassment.

How does this term work if it is applied to healthcare? This article explores the use of language, including this term, in infection prevention, and argues that applying a zero-tolerance policy to healthcare-associated infection is unrealistic due to the myriad factors involved. If infection does occur it will likely be seen as a mistake or failure. Having this ideal but unachievable aim can make it difficult for staff to deal with the reality, leaving them trying to hide poor practice instead of addressing how it can be improved.


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