Hospital Acquired Infections A hospital acquired infection is an infection that is acquired by a patient while receiving treatment in hospital. The patient was admitted in hospital for the treatment of a different disease however on being discharged it is discovered he has acquired an infection during his stay. These infections are known as nosocomial infections. Researchers released a report that stated that hospital acquired infections killed 48,000 people every year. Sepsis and Pneumonia were found to be the most common infections. The hospital discharge records of forty states were examined in the period 1998 and 2006 showing the infections cost $8 billion on treatment and lead to over 2 million days in hospitalization per year (Michael, Laxminarayan, Perencevich & Malani, 2010) The staff at the hospital may also be infected. The patients who mostly get the infections are those in acute care. There are several factors that have led to the rise in hospital infections such as the numerous varieties of medical procedures involving invasive techniques. In a research study carried out, hospital infections were on the rise in hospitalized children and adults waiting in hospital for surgery. Over 10.5 million medical records were examined and it was revealed that the bacterium, C-difficle was dangerously affecting the patients. The bacterium inflames the colon causing the patient to diarrhea. It also increased the risk of further hospitalization, surgery and death. The bacteria is also linked to the patients who overuse antibiotics and heartburn drugs (Nylund, Goudie, Garza, Fairbrother, Cohen, 2010). There is also decreased immunity against diseases among the patients. It is wrong when patients are prescribed for antibiotics yet they do not need them.
It is also not advisable for a patient to fail to finish an antibiotic prescribed dose. Both actions increase the rate of infection as it creates a breeding ground for the bacteria. It makes the bacteria resistant to further medication. In hospitals with poor infection control practices, the drug resistant infections are transmitted easily among patients. Other factors that increase the rate of infection are the number of patients that are malnourished or have injuries to the skin and the unhygienic environments hospitals. A study carried out in two hospitals, Montreal General and Royal Victoria, examined the rate of acquisition of hospital acquired acquisitions when patients are moved from a multiple bed to single bed room status. The study was carried out to verify the common held belief that single patient rooms provided higher protection against hospital infections. It was carried out in the intensive care units of the hospital. The results showed that the infection rate fell by 50% for the three hospital infections, Enterococcus, C-difficile and Staphylococcus in the patients who moved to single bed rooms. There was also a reduction of 10% in the duration of time a patient was admitted at the hospital. The study covered the period 2000 to 2005. It was further revealed that on average a case of C-difficile cost $7,000 per year in treatment. There are tremendous savings in using single-bed rooms (Teltsch, Hanley, Loo, Goldberg, Gursahaney & Buckeridge, 2011)
These nosocomial infections are found both in the developed and third world countries. There are people who die from these infections while others are affected in terms of restricted mobility leading to prolonged stay at the hospital.
These diseases may also affect the community when the patient is discharged leading to more sick people. Businesses are affected in terms of lost working hours. The treatment of these infections is a huge cost to the patients and the health institutions. The other common hospital infections are urinary tract infections, lower respiratory infections and infections of surgical wounds. The highest rate of infection is experienced in the intensive care units and the surgical wards. The resources that the hospital would have used for the treatment of serious diseases are used to treat infections that can be prevented. On preventing hospital infections all the people in the health profession need to be involved. There should be a regional or national program to assist hospitals to minimize the rate of infection. The objectives of the program should be identified and guidelines given to hospitals on health care surveillance and control practices. The hospitals should be monitored to see if the control practices being used are effective at all. There should be a yearly plan on how the hospital intends to minimize the rate of infection and monitoring tools be put in place. The senior management of the hospital should be fully involved in the initiative. They should establish an Infection Control Committee to oversee the control measures. Physicians and health professionals should be trained and given materials on hygiene. In the different departments in hospital such as nursing, laundry and housekeeping, there should be champions on hygiene. The policies and guidelines released by the infection committee should be looked at by management so that they can fully give their support. The infection committee should have the necessary authority to implement the infection Control policies (Ducel, Fabry & Nicole, 2002).
The management should also get involved in outbreak investigations. The hospital needs to evaluate its hygiene and safety policies and procedures and measure its adequacy in preventing hospital infections. Environmental cleanliness should be maintained at all times. In the food department the director of the catering department should ensure that there are guidelines in the purchase of foodstuffs and that hygiene is observed in the kitchen. The equipment and the storage areas should be kept clean. There should be policies and instructions issued to the catering staff on hand washing and disinfection processes. The methods used by the hospital in the preparation and distribution of food should also be hygienic. The staff should go through training on food safety. The methods used by the staff in disposing wastes should be appropriate. The laundry department should ensure the beddings and clothes are changed frequently. The dirty linen should be disinfected appropriately. When the laundry is being transported from the laundry room to the wards the staff should ensure there is no contamination. The housekeeping department should ensure that all the rooms are cleaned appropriately. Washing items such as soaps should be replenished regularly. The pest control services in the hospital should be at the optimum level. There is the prevention of patient to patient infections through washing hands, using gloves, isolation and other sterilization practices. The physicians and nurses need to be even more diligent as they have the most contact with the patients. The physicians have a role to provide patient care in a way that minimizes infection. They should be more careful when performing invasive procedures. The invasive procedures should be minimized and other procedures used where possible.
They should ensure they wash their hands and use sterilized equipment. Furthermore the physicians should serve and even support the Infection Control Board. All cases of infection should be notified to the board and the hospital management for control purposes. The physician should advise patients and visitors on the importance of hygiene. The nurse should also observe hygiene and report any evidence of infection immediately to the physician. The patient should be isolated to prevent infection of other patients, staff or visitors.
In a research carried out in hospitals, it was found out that when there is an outbreak of hospital infections, contaminated hands are often the medium used in transmitting the infections (Larson, 1988). It was revealed that when a hospital ensures decontamination of hands the rate of infection is drastically reduced.The hands should be washed depending on the frequency of contact with patients and the type of health care the physician is providing to the patients. For hand washing the patients and staff should use running water and anti-septic soaps. The towels used to dry the hands should be clean and preferably disposable. There should be training on hand washing so that people know the correct way to wash hands. Most people never remove rings or bracelets when washing their hands. The hand and the forearm may need to be washed in some instances. There should be safe infection practices practiced. The physicians should avoid and eliminate unnecessary injections. There should be no rush at all to inject the patients. The needles and the syringes that are used should be sterile and preferably disposable. The disposal of the injections should also be carried out appropriately.
The physicians and nursing staff should wear gloves for their own protection. Sterile gloves should be worn during surgery and other invasive procedures. The hands should be washed once someone stops using the gloves. The gloves that are disposable should not be reused by staff. The staff to ensure they always wear masks in the operating rooms or when handling patients with airborne diseases. The patients with airborne diseases should also wear masks when venturing outside their rooms. In terms of clothing for the health professionals, the material should be easy to clean and sterilize. If the staff is exposed to blood or any other kind of discharge the uniform should also be changed. The shoes that are worn by the staff should not be worn anywhere else. They should also be fairly easy to clean. The patients should have good nutrition and be vaccinated appropriately.
The patient equipment should be disinfected and sterilized appropriately. The hospital should be controlling the outbreaks and monitoring the rates of infections to see if there is any improvement. The hospital will be better prepared to handle it where there is early identification of the outbreak. There should be investigations carried out to find out the causes of the infection and control measures put in place. The patients with the infections may need to be isolated. An outbreak occurs when there is an unexpected increase in the rate of infections.
Conclusion
As mentioned in the prevention practices, these are infections whose transmission and infection can be drastically prevented both in the developed and developing countries simply by observing hygiene and cleanliness. The prevention of hospital acquired infections requires all the people involved to work together to contain the infection. Any department in the hospital that does not perform its role provides a break in the chain leading to chaos.
References
Ducel, G., Fabry, J. & Nicole, L. (2002). Prevention of Hospital-Acquired Infections.
Retrieved from: http://www.who.int/csr/resources/publications/whocdscsreph200212.pdf
Larson, E. (1988). Cause Link between Hand Washing and Risk of Infection? Examination
of the evidence. Infect Control Hosp Epidemiol, Vol. 9, 28–36.
Michael, R., Laxminarayan, R., Perencevich, E. & Malani, A. (2010). Clinical and
Economic Outcomes Attributable to Health Care–Associated Sepsis and Pneumonia
Archives of Internal Medecine, Vol 170(4), 347-353.
Nylund, C., Goudie, A., Garza, J., Fairbrother, G. & Cohen, M. (2010). Clostridium
difficile Infection in Hospitalized Children in the United States Archives of Pediatric and Adolescent Medicine. Retrieved from: http://archpedi.amaassn.org/cgi/content/short/archpediatrics.2010.282
Teltsch, D., Hanley, J., Loo, V., Goldberg, P., Gursahaney, P., & Buckeridge, D.
(2011). Infection Acquisition Following Intensive Care Unit Room Privatization. Journal Archives of Internal Medicine, Vol 171(1), 32-38.
