The purpose of this research paper is to evaluate Healthcare-Associated Infections (HAI), a common complication of hospital care and one of the top leading causes of death in the United States. The paper will explore the current issues of HAI, the problem examined, the significance, and what methods are currently being implemented to reduce the problem. Problem Background The challenge that many hospital facilities are facing is how to avoid HAIs while treating patients for medical conditions.
HAIs are infections caused by a variety of common bacteria, fungi and viruses that spread during the course of patients receiving medical care (“Enhancing Patient,” p. 118). They can also occur during the course of receiving treatment at home. Morbidity and Mortality are enormous issues associated with HAIs as 10 percent of all hospital admissions are complicated by these infections in both the United States and Western Europe.
Just in the United States alone, an estimated 1. -2 million people develop an HAI per year, killing nearly 100,000 people; based on these estimates, HAIs are considered as one of the top 10 leading deaths in the United States (“Enhancing Patient,” p. 118). Hospital-related HAIs alone are responsible for more than $30 billion dollars in preventable healthcare expenses yearly and are largely preventable and can be drastically reduced to save lives and avoid excessive costs (Wright, 2012, p. 8).
The results of HAIs have not only left a tangible toll on the healthcare system, but it has also played a significant role in the loss of consumer confidence in the healthcare system. In response to this problem consumer advocacy groups, federal and state governments and health professionals have stepped up the pressure to make reduction of HAIs a national priority (“Enhancing Patient,” p. 118). Now that we understand the issue of HAIs, this paper will address methods to help reduce the problem.
The following literature review will analyze five academic articles that deal with HAI and how to implement actions to prevent these infections. Literature Review HAI Reduction Methods Wright’s (2012) reports that there is no one simple formula that will lead to the prevention and elimination of HAIs in every setting and every facility and for every patient; however, well-established strategies to prevent and eventually eliminate HAIs have been tested and proven. “These strategies include actions taken during patient care in the clinic and at the bedside; actions taken by executives, managers, and administrators of facilities and health systems; and abroad-based system changes that involve focused and concerted efforts by everyone … Monitoring and measuring HAIs is a critical component of the overall strategy to prevent and reduce HAIs” (Wright, 2012, p. 11).
Boyce (2012) found that Central line-associated bloodstream infections (CLABSIs) is a continued important healthcare problem in the U. S. , as a substantial proportion now occurs in outpatient settings. Many of these infections are due to nontunneled catheters or long-term tunneled hemodialysis catheters and are referred to as HD CLABSIs (Boyce, 2012, p. 936). In 2008, an estimated 37,000 HD-CLABSIs occurred among patients receiving outpatient hemodialysis requiring hospitalization. “In addition to the substantial morbidity and mortality suffered by affected patients, CLABSIs add significant cost to the healthcare system” (Boyce, 2012, p. 936).
Boyce (2012) suggests using a combination bundle of infection control measures have been shown to reduce CLABSI and is strongly recommended by a variety of healthcare organizations. The bundle includes hand hygiene prior to inserting the line, use of maximal barriers precautions when inserting central lines, cleansing of the skin at the catheter entry site, avoiding femoral line insertion whenever possible, and removing catheters when no longer indicated (Boyce, 2012, p. 937). Kuper, K. M. , & Sertimus, E. J. 2009) examined how pharmacists can make a major impact on helping prevent HAIs.
“Simple hand washing and compliance with infection-control isolation guidelines that are posted outside of patients rooms are easy ways to minimize the spread of potentially infectious diseases to other patients and healthcare providers; Pharmacy staff involved in the preparations of intravenous medications should adhere to guidelines on compounding sterile preparations to minimize products contamination that could subsequently lead to an HAI” (Kuper, K. M. , & Sertimus, E. J. , 2009, p. 493). Other effective ways to prevent infections mentioned in the article are immunization protocols that involve patient screening and vaccination by pharmacists and other healthcare professionals. Umscheid et al. (2011) estimated a proportion of HAIs that are preventable in the U. S. hospitals as well as their associated mortality rates and costs.
Their results found that past studies have estimated the number of infections prevented or lives saved if hospitals followed best practices in infection prevention and control. The goal of preventing 100 percent of HAIs may not be attainable even with the use of current evidence-based HAI prevention strategies, however comprehensive implementation of such strategies could prevent hundreds of thousands of HAIs and save tens of thousands of lives and billions of dollars” (Umscheid et al, 2001, p. 111). Zerr, Milestone and Huskins et al (2010) examined viral respiratory infections in children younger than five years in the United States. Viral respiratory infections cause morbidity and mortality in pediatric populations.
The study revealed that children younger than five years infected with Viral respiratory infections estimated at 180 hospitalizations per 10,000 children per year. In a 2009 study on pandemic influenza H1N1 virus, relating to viral respiratory infections, the researchers focused on determining three issues: isolation of patients with suspected or confirmed H1N1 influenza, use of personal protective equipment by healthcare providers (HCPs), hospital influenza vaccination programs for the patients and of the HCPs. Low rates of HCP vaccination have been associated with influenza outbreaks and with high rates of healthcare-associated influenza, not only in long-term care settings, but also in acute care settings, including neonatal intensive care units and tertiary care academic hospitals” (Zerr, Milestone and Huskins, 2010, p 524). Based on their findings, development of a new generation of respirators that enhance safety, comfort and the ability to perform work-related tasks is desperately needed in the cases of H1N1.
Now that we have reviewed the literature from researched academic studies, this paper will review what the U. S. federal government is currently implementing to reduce the problem of HAIs. The Centers for Disease Control and Prevention (2010) performs a number of HAI prevention research studies ranging across a wide spectrum of topics. Through this research CDC conducts a variety of laboratory research studies. One in particular is developing “models for testing efficacy of disinfectants in water distribution centers to reduce opportunistic pathogens in healthcare water systems” (CDC 2010).
The U. S. Department of Health and Human Services (2011) developed a “new public-private partnership to make hospital care safer, more reliable and inexpensive” by keeping hospital patients from getting injured or sicker and helping patients heal without complication (HHS 2011). The U. S. Food and Drug Administration has established workshops to discuss the best methods in reprocessing reusable medical devices. To avoid any risk infection by a contaminated device, reusable device undergo reprocessing, a detailed multistep process to clean and disinfect or sterilize the devices” (FDA 2011).
The Agency for Healthcare Research and Quality developed a new online “Toolkit for Reduction of Clostridium difficile Infections Through Antimicrobial Stewardships, to help hospitals improve the use of antibiotics by implementing an Antimicrobial Stewardship Program (ASP) directly targeting C. difficile infections” (AHRQ 2011). Now that we know what U. S. ederal officials are doing to reduce HAIs, this paper will review what government officials in United Kingdom, Canada, Australia and New Zealand are doing to reduce HAIs. According to Department of Health UK (2012), programs such as National Institute for Health and Clinical Excellence (NICE) and Health Protection Agency (HPA) have partnered up to produce a “quality improvement guide for board members working in or with hospitals; and, it aims to reduce the risk of harm for (HAIs) patients, staff and visitors and reduce the costs associated with preventable infection” (NICE 2011).
The Public Health Agency of Canada has established methods for preventing cross-transmission of HAIs by following education and training programs and requiring healthcare workers and home care providers to regularly undergo assessment of their competency as well as follow hand hygiene, proper glove usage, wearing gowns during procedures and eye protection/face shields (PHAC 2012). In Australia, the National Health and Medical Research Council’s approach to preventing and reducing HAIs involve “applying a risk-management framework to manage uman and system factors associated with the transmission of infectious agents” (NHMRC 2011).
In New Zealand, Health Quality and Safety Commission joined in partnership with the Auckland DHB to implement a national hand hygiene program. “Scientific evidence shows that microbes causing HAI are most frequently spread between patients via the hands of healthcare workers. Hand hygiene is a simple, low-cost action to prevent the spread of all microbes that cause HAI. While hand hygiene is not the only measure to counter HAI, compliance with it alone can dramatically enhance patient safety” (HQSE 2013).