Healthcare-acquired infections (HAIs), also known as nosocomial infections, are infections that patients get while receiving treatment for medical or surgical conditions. HAIs occur in all settings of care, including hospitals, surgical centers, ambulatory clinics, and long-term care facilities such as nursing homes and rehabilitation facilities.
Who's At Risk?
All hospitalized patients are susceptible to contracting a nosocomial infection. Some patients are at greater risk than others-young children, the elderly, and persons with compromised immune systems are more likely to get an infection. Other risk factors are long hospital stays, the use of indwelling catheters, failure of healthcare workers to wash their hands, and overuse of antibiotics.
In American hospitals alone, the Centers for Disease Control (CDC) estimates that HAIs account for an estimated 1.7 million infections and 99,000 associated deaths each year. Of these infections:
- 32 percent of all healthcare-acquired infection are urinary tract infections
- 22 percent are surgical site infections
- 15 percent are pneumonia (lung infections)
- 14 percent are bloodstream infections
What's at Stake?
Patients who acquire infections from surgery spend, on average, an additional 6.5 days in the hospital, are five times more likely to be readmitted after discharge and twice as likely to die. Moreover, surgical patients who develop infections are 60 percent more likely to require admission to a hospital's intensive care unit. Surgical infections are believed to account for up to ten billion dollars annually in healthcare expenditures.
What are Providers Are Doing to Prevent HAIs?
Recent reports have shown that many HAIs can be prevented through strict adherence to evidence-based best practices. Recommendations include:
- healthcare providers cleaning their hands with soap and water or an alcohol-based hand rub before and after caring for every patient;
- catheters being used only when necessary and removed as soon as possible;
- cleaning the skin where the catheter is being inserted or the surgical site, and
- providers wearing hair covers, masks, gowns and gloves when appropriate.
Healthcare providers are making great strides to reduce, and in some cases eliminate, HAIs. In this section, resources are identified and case study examples are highlighted to assist healthcare providers to improve the prevention of HAIs.
How Can You Protect Yourself Against HAIs?
The CDC has released these example questions for patients to raise to their nurses and doctors to protect themselves from Healthcare-associated Infections.
CDC Checklist for Core Elements of Hospital Antibiotic Stewardship Programs
The checklist (link below) is a companion to Core Elements of Hospital Antibiotic Stewardship Programs. This checklist should be used to systematically assess key elements and actions to ensure optimal antibiotic prescribing and limit overuse and misuse of antibiotics in hospitals. CDC recommends that all hospitals implement an Antibiotic Stewardship Program.
Click here for checklist
CDC - HAI Reduction and Implementation Tool Kits
The American Recovery and Reinvestment Act of 2009, Public Law 111-5 (ARRA), was signed into law on February 17, 2009. Within the Recovery Act, $50 million was authorized to support states in the prevention and reduction of healthcare-associated infections. Many of these funds are being used to support activities outlined in the HHS Action Plan to Prevent Health Care-Associated Infections. This CDC site tracks states' efforts to meet the goals of the plan and the results can be located on the CDC Healthcare-Associated Infections: Recovery Act site. CDC is assisting states in this process with implementation tool kits located at Premier's Safety Institute's Healthcare-Associated Infection Web site.
- CLABSI (Catheter-related bloodstream infection)
- C.diff (Clostridium difficile infection)
- CAUTI (Catheter-related urinary tract infections)
- MRSA (Methicillin-resistant S. aureus)
- SSI (Surgical site infection
Cambridge Health Alliance undertook an Agency for Healthcare Research & Quality-sponsored 15-month safety improvement program to reduce infections in the ICU at its Cambridge and Everett hospitals. The effort – involving an assessment of potential problems, increased staff education, use of proven best practices, leadership buy-in and more – resulted in a dramatic reduction in urinary tra...» Full Article
Healthcentric Advisors would like to invite you to visit The Learning Center, our no cost virtual online learning system, with an Introduction to Statistics and Epidemiology in Infection Prevention. Through this interactive and self-paced module, you will learn about statistical and epidemiological methods that are used in infection prevention and control. New courses will also cover interpreting ...» Full Article
WHO. Health care without avoidable infections:The critical role of infection prevention and control. www.WHO/HIS/SDS/,2016.
Garner JS, Jarvis WR, Emori TG, Horan TC. Hughes JM. CDC definitions for nosocomial infections. Am Rev Respir Dis. 1988;16:128–40.
CAS Google Scholar
Lipsett PA. Nosocomial infections. Surgery, Springer New York. 2008;91:273–86.
Google Scholar
Umscheid CA, Mitchell MD, Doshi JA, Agarwal R, Williams K, Brennan PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol. 2011;32:101–14.
Article Google Scholar
Erbay RH, Yalcin AN, Zencir M, Serin S, Atalay H. Costs and risk factors for ventilator-associated pneumonia in a Turkish University Hospital's intensive care unit: a case-control study. BMC Pulm Med. 2004;4:1–7.
Article Google Scholar
Cassini A, Plachouras D, Eckmanns T, et al. Burden of six healthcare-associated infections on European population health: estimating incidence-based disability-adjusted life years through a population prevalence-based modelling study. PLoS Med. 2016;13:e1002150.
Article Google Scholar
Rosenthal VD, Maki DG, Mehta Y, et al. International nosocomial infection control consortium (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module. Am J Infect Control. 2014;42:942–56.
Article Google Scholar
WHO. Report on the burden of endemic health care-associated infection worldwide. World Health Organization 2011.
Google Scholar
Zarb P, Coignard B, Griskeviciene J, et al. The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use. Euro Surveill. 2012;17:4–19.
Article Google Scholar
Magill SS, Hellinger W, Cohen J, et al. Prevalence of healthcare-associated infections in acute care hospitals in Jacksonville, Florida. Infect Control Hosp Epidemiol. 2012;33:283–91.
Article Google Scholar
Yallew WW, Kumie A, Yehuala FM. Point prevalence of hospital-acquired infections in two teaching hospitals of Amhara region in Ethiopia. Drug Healthcare Patient Safety. 2016;8:71–6.
Article Google Scholar
Alvarez-Lerma F, Gracia-Arnillas MP, Palomar M, et al. Urethral catheter-related urinary infection in critical patients admitted to the ICU. Descriptive data of the ENVIN-UCI study. Med Int. 2013;37:75–82.
CAS Google Scholar
Pieri M, Agracheva N, Fumagalli L, et al. Infections occurring in adult patients receiving mechanical circulatory support: the two-year experience of an Italian National Referral Tertiary Care Center. Med Int. 2013;37:468–75.
CAS Google Scholar
Apostolopoulou E, Raftopoulos V, Filntisis G, et al. Surveillance of device-associated infection rates and mortality in 3 Greek intensive care units. Am J Crit Care. 2013;22:12–20.
Article Google Scholar
Tao L, Hu B, Rosenthal VD, Gao X, He L. Device-associated infection rates in 398 intensive care units in Shanghai, China: international nosocomial infection control consortium (INICC) findings. Int J Infect Dis. 2011;15:e774–80.
Article Google Scholar
Meric M, Willke A, Caglayan C, Toker K. Intensive care unit-acquired infections: incidence, risk factors and associated mortality in a Turkish university hospital. Jpn J Infect Dis. 2005;58:297–302.
PubMed Google Scholar
Yallew WW, Kumie A, Yehuala FM. Risk factors for hospital-acquired infections in teaching hospitals of Amhara regional state, Ethiopia: a matched-case control study. PLoS One. 2017;12:e0181145.
Article Google Scholar
Brown RB, Hosmer D, Chen HC, et al. A comparison of infections in different ICUs within the same hospital. Crit Care Med. 1985;13:472–6.
CAS Article Google Scholar
Spencer RC. Epidemiology of infection in ICUs. Intensive Care Med. 1994;20:S2–6.
Article Google Scholar
Eggimann P, Pittet D. Infection control in the ICU. Chest. 2001;120:2059–93.
CAS Article Google Scholar
Richards M, Thursky K, Buising K. Epidemiology, prevalence, and sites of infections in intensive care units. Semin Respir Crit Care Med. 2003;24:3–22.
Article Google Scholar
Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008;36:309–32.
Article Google Scholar
Cavalcanti M, Valencia M, Torres A. Respiratory nosocomial infections in the medical intensive care unit. Microbes Infect. 2005;7:292–301.
Article Google Scholar
Corrado A, Roussos C, Ambrosino N, et al. Respiratory intermediate care units: a European survey. Eur Respir J. 2002;20:1343–50.
CAS Article Google Scholar
Agarwal R, Gupta D, Ray P, Aggarwal AN, Jindal SK. Epidemiology, risk factors and outcome of nosocomial infections in a respiratory intensive care unit in North India. J Inf Secur. 2006;53:98–105.
Google Scholar
Confalonieri M, Gorini M, Ambrosino N, Mollica C, Corrado A. Respiratory intensive care units in Italy: a national census and prospective cohort study. Thorax. 2001;56:373–8.
CAS Article Google Scholar
Rozaidi SW, Sukro J, Dan A. The incidence of nosocomial infection in the intensive care unit, hospital Universiti Kebangsaan Malaysia: ICU-acquired nosocomial infection surveillance program 1998-1999. Med J Malays. 2001;56:207–22.
CAS Google Scholar
Rosenthal VD, Maki DG, Jamulitrat S, et al. International nosocomial infection control consortium (INICC) report, data summary for 2003-2008 issued June 2009. Am J Infect Control. 2010;38:95–104.
Article Google Scholar
Rosenthal VD, Maki DG, Mehta A, et al. International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009. Am J Infect Control. 2012;40:396–407.
Article Google Scholar
Meric M, Baykara N, Aksoy S, et al. Epidemiology and risk factors of intensive care unit-acquired infections: a prospective multicentre cohort study in a middle-income country. Singap Med J. 2012;53:260–3.
Google Scholar
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