Rumors abound that hospitals can’t be clean with all those diseases around, that staff may or may not wash their hands, or that overuse of antibiotics produces superbugs. It’s true that hospitals have several special challenges toward their goal of preventing infection. In fact, prevention of health care-associated infections is one of the most challenging issues in the industry today.
HAIs are infections resulting from treatment in a hospital or health care facility not related to the patient’s original condition. For instance, an elderly person may come to the hospital to have hip surgery, but during his or her recovery period develop pneumonia. These infections can be serious. A recent report published by the Centers for Disease Control and Prevention estimated the number of U.S. deaths from HAIs in 2002 at nearly 99,000. Also, at any given time 1.4 million people worldwide suffer from infections acquired in hospitals.
Why, if you go into a hospital, are you at more risk of getting an infection?
• Many sick people have compromised immune systems.
• Hospitalized patients are sicker today than in the past. Many more procedures are done on an outpatient basis today, so the people who do stay in the hospital usually are very ill.
• Many medical procedures involve putting something foreign into the body, such as a pin to repair a hip or an in-dwelling intravenous catheter. Any time a foreign object is introduced, it brings with it a higher chance of infection.
• Medical staff move from patient to patient, providing a way for germs to spread.
How can hospitals battle these challenges? Critical to gaining control over HAIs is establishing a surveillance program. This data gathering identifies sources of infections and tracks infection rates, as well as prevalence of certain types of infections.
Once armed with this information, health care facilities are able to establish infection prevention and control plans. An infection control program is designed to reduce HAIs for patients and for health care workers. Primary methods are to emphasize early recognition of risk and use of prevention and control measures. The goals of an infection control program are to protect the patient, health care workers, visitors and others in the health care environment.
It also is crucial for hospitals to provide continuing education among our health care professionals about the latest in best practices associated with infection prevention. This is one of the most effective measures for controlling the risk of HAIs. This education can be as simple as explaining the critical need for hand washing with every action - staff, patients and families are continually reminded to wash their hands if they have not done so.
One common HAI is ventilator-acquired pneumonia, or VAP. Routine and thorough oral care for patients requiring mechanical ventilation (a breathing machine) helps prevent VAP. It is essential that trauma patients with a breathing tube have complete oral hygiene to prevent respiratory infections. Another way to reduce risk is to reduce the length of time invasive tubes such as intravenous catheters, urinary tract catheters and ventilators are used.
Last, but critical to preventing infections, is providing adequate disinfection of rooms after patients are discharged.
Preventing HAIs is a team effort. It requires patient and family involvement, staff members from every department within the hospital, and administrative support. These infections are preventable with lots of hard work, determination and communication.
Joyce Dombrouski is vice president of nursing at St. Patrick Hospital and Health Sciences Center. Questions for our clinicians? Please send them to info@saintpatrick.org.
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