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    Healthcare-associated infections, also known as nosocomial infections or HAIs, are a worldwide problem in every healthcare system. And while the U.S. has made progress in decreasing the rate of HAIs, it still remains a burden to both the individual and the healthcare system. In this article, we will discuss the types and causes of HAIs, recent data on HAIs as provided by the Center for Disease Control and Prevention (CDC), and ways to improve patient outcomes.

    Classification of HAIs

    A healthcare-associated infection is a condition acquired while obtaining medical care that was not present [in the patient] at the time of admittance. Simply put, it is an infection that came from the medical care environment or agents and patients thereof. The nature of these infections vary, and the Centers for Disease Control and Prevention divides them into : central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), and ventilator-associated pneumonia (VAP).

    CLABSI (Central line-associated bloodstream infections)

    CLABSIs are symptomized with fevers, chills, and/or skin that becomes red around the area of the catheter. CLABSIs are a laboratory-confirmed infection in the bloodstream of a patient who either has a central line at the time of the infection or has had a central line within the past forty-eight hours of the infection. A blood culture taken from an infected patient will show that there is evidence of a problem, and, if there are no other possible sites that this infection could be stemming from, the likelihood is that it is due to a central line.

    CAUTI (Catheter-associated urinary tract infections)

    CAUTIs are an infection in the urinary system, and it can be incredibly painful for patients. Urinary tract infections (UTIs) are among the most common HAIs reported to the National Healthcare Safety Network. 75% of UTIs acquired in the hospital are . A catheter is a tube inserted into the bladder in the urethra in order to drain a patient’s urine. One of the most common reasons for a CAUTI is prolonged use of a catheter for an inappropriate amount of time. Symptoms of a CAUTI include bloody urine, clouded urine, urine leakage around the catheter, chills, fever, fatigue, and pain or discomfort in the lower back or stomach.

    SSI (Surgical site infections)

    An SSI is an infection that occurs post-surgery in or around the surgical site. These can be skin-deep infections, or they can go beyond the superficial and cause serious blood, tissue, and organ damage. Symptoms of SSIs include fever, redness and/or pain at the location of the surgical site, as well as leaky, clouded fluid draining from the surgical wound. Most SSIs can be successfully treated with antibiotics.

    VAP (Ventilator-associated pneumonia)

    VAPs develop 48 hours or longer after ventilation is given through a tracheotomy or endotracheal tube. VAPs occur when microorganisms infect the lung parenchyma and lower respiratory tract. Intubation can compromise the oropharynx and allow gastric secretions into the lower airway, causing serious respiration problems. The symptoms of VAP include fever, chills, thick green mucus, bluish color of extremities, cough, nausea, vomiting, and/or shortness of breath.

    Two other sources of infections that should be mentioned are HA-MRSA and Clostridium difficile:

    MRSA, also known as hospital-associated Methicillin-resistant Staphylococcus aureus, is a type of infection that has garnered a lot of recent attention. It is caused by staph bacteria and is resistant to antibiotics used to treat regular staph infections. HA-MRSA occurs when there are invasive procedures such as surgeries, IVs, or artificial joints. HA-MRSA is symptomized by skin that is red, swollen, painful, full of pus or other drainage, and warm to the touch. It is also accompanied by fever and chills.

    Clostridium difficile (c. diff) is a germ that causes diarrhea, and often occurs in patients taking antibiotics. C. diff spores can live outside the body and can be found on medical equipment. Most C. diff cases are treatable through antibiotics, but in certain severe cases, surgery intervention to remove the infected part of the intestines is required.

    HAI Data

    The most recent data for HAIs was compiled in 2014 and published in 2016 by the Centers for Disease Control and Prevention (CDC) in their annual 1. Some key takeaways include:

    • There were 721,800 HAIs, with VAP comprising 157,500, CAUTI comprising 93,300, SSI comprising 157,500, CLABSI comprising 71,900, and other less-common infections making up the remainder.
    • There was a 50% decrease in CLABSI between 2008 to 2014.
    • Ther

       

      Understanding Healthcare-Associated Infections

      Healthcare-associated infections, also known as nosocomial infections or HAIs, are a worldwide problem in every healthcare system. And while the U.S. has made progress in decreasing the rate of HAIs, it still remains a burden to both the individual and the healthcare system. In this article, we will discuss the types and causes of HAIs, recent data on HAIs as provided by the Center for Disease Control and Prevention (CDC), and ways to improve patient outcomes.

      Classification of HAIs

      A healthcare-associated infection is a condition acquired while obtaining medical care that was not present [in the patient] at the time of admittance. Simply put, it is an infection that came from the medical care environment or agents and patients thereof. The nature of these infections vary, and the Centers for Disease Control and Prevention divides them into : central line-associated bloodstream infection (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), and ventilator-associated pneumonia (VAP).

      CLABSI (Central line-associated bloodstream infections)

      CLABSIs are symptomized with fevers, chills, and/or skin that becomes red around the area of the catheter. CLABSIs are a laboratory-confirmed infection in the bloodstream of a patient who either has a central line at the time of the infection or has had a central line within the past forty-eight hours of the infection. A blood culture taken from an infected patient will show that there is evidence of a problem, and, if there are no other possible sites that this infection could be stemming from, the likelihood is that it is due to a central line.

      CAUTI (Catheter-associated urinary tract infections)

      CAUTIs are an infection in the urinary system, and it can be incredibly painful for patients. Urinary tract infections (UTIs) are among the most common HAIs reported to the National Healthcare Safety Network. 75% of UTIs acquired in the hospital are . A catheter is a tube inserted into the bladder in the urethra in order to drain a patient’s urine. One of the most common reasons for a CAUTI is prolonged use of a catheter for an inappropriate amount of time. Symptoms of a CAUTI include bloody urine, clouded urine, urine leakage around the catheter, chills, fever, fatigue, and pain or discomfort in the lower back or stomach.

      SSI (Surgical site infections)

      An SSI is an infection that occurs post-surgery in or around the surgical site. These can be skin-deep infections, or they can go beyond the superficial and cause serious blood, tissue, and organ damage. Symptoms of SSIs include fever, redness and/or pain at the location of the surgical site, as well as leaky, clouded fluid draining from the surgical wound. Most SSIs can be successfully treated with antibiotics.

      VAP (Ventilator-associated pneumonia)

      VAPs develop 48 hours or longer after ventilation is given through a tracheotomy or endotracheal tube. VAPs occur when microorganisms infect the lung parenchyma and lower respiratory tract. Intubation can compromise the oropharynx and allow gastric secretions into the lower airway, causing serious respiration problems. The symptoms of VAP include fever, chills, thick green mucus, bluish color of extremities, cough, nausea, vomiting, and/or shortness of breath.

      Two other sources of infections that should be mentioned are HA-MRSA and Clostridium difficile:

      MRSA, also known as hospital-associated Methicillin-resistant Staphylococcus aureus, is a type of infection that has garnered a lot of recent attention. It is caused by staph bacteria and is resistant to antibiotics used to treat regular staph infections. HA-MRSA occurs when there are invasive procedures such as surgeries, IVs, or artificial joints. HA-MRSA is symptomized by skin that is red, swollen, painful, full of pus or other drainage, and warm to the touch. It is also accompanied by fever and chills.

      Clostridium difficile (c. diff) is a germ that causes diarrhea, and often occurs in patients taking antibiotics. C. diff spores can live outside the body and can be found on medical equipment. Most C. diff cases are treatable through antibiotics, but in certain severe cases, surgery intervention to remove the infected part of the intestines is required.

      HAI Data

      The most recent data for HAIs was compiled in 2014 and published in 2016 by the Centers for Disease Control and Prevention (CDC) in their annual 1. Some key takeaways include:

      • There were 721,800 HAIs, with VAP comprising 157,500, CAUTI comprising 93,300, SSI comprising 157,500, CLABSI comprising 71,900, and other less-common infections making up the remainder.
      • There was a 50% decrease in CLABSI between 2008 to 2014.
      • There was no change in the level of CAUTI between 2009 and 2014.
      • There was a 17% decrease in SSI, with particularly noticeable decreases in SSI relating to abdominal surgeries and colon surgeries.
      • There was a 9% decrease in CLABSI and a 14% decrease in CAUTI in long-term care hospitals.
      • There was a 13% decrease in HA-MRSA, a common bloodstream infection, between 2011 and 2014, as well as an 8% decrease in Clostridium difficile, a common hospital infection.

      Improving Patient Outcomes

      These statistics are heartening, and show an encouraging trend towards reduction of HAIs, with the exception of CAUTI. The efforts of infection preventionists, medical suppliers, and the ongoing efforts of medical professionals around the country to lessen the burdens of HAIs have no-doubt been responsible. But while this positive trend is certainly encouraging, we must continue our efforts.

      With the influx of new devices into the care environment, it is important to retain a holistic view of infection prevention, since every new device, especially the touch screen devices we have come to rely so heavily upon, is a potential route for the transmission of infectious cultures. Medical suppliers like have developed materials and formulations to give medical professionals the tools they need to keep these new devices and their screens clean without the risk of damage. The chemical compatibility between cleaning and disinfecting agents and the materials of modern medical devices is now being more thoroughly researched to provide better solutions for tomorrow’s doctors and patients. And while there is not yet any national standard on the presence and use of many of the touchscreen devices that have entered the environment of care, many care facilities have already developed and integrated their own protocols for the handling of these devices. And many medical professionals have called out for the national standards they feel will be an important tool in the fight against HAIs.

      1 Centers for Disease Control and Prevention. (2016, March).

      e was no change in the level of CAUTI between 2009 and 2014.

    • There was a 17% decrease in SSI, with particularly noticeable decreases in SSI relating to abdominal surgeries and colon surgeries.
    • There was a 9% decrease in CLABSI and a 14% decrease in CAUTI in long-term care hospitals.
    • There was a 13% decrease in HA-MRSA, a common bloodstream infection, between 2011 and 2014, as well as an 8% decrease in Clostridium difficile, a common hospital infection.

    Improving Patient Outcomes

    These statistics are heartening, and show an encouraging trend towards reduction of HAIs, with the exception of CAUTI. The efforts of infection preventionists, medical suppliers, and the ongoing efforts of medical professionals around the country to lessen the burdens of HAIs have no-doubt been responsible. But while this positive trend is certainly encouraging, we must continue our efforts.

    With the influx of new devices into the care environment, it is important to retain a holistic view of infection prevention, since every new device, especially the touch screen devices we have come to rely so heavily upon, is a potential route for the transmission of infectious cultures. Medical suppliers like have developed materials and formulations to give medical professionals the tools they need to keep these new devices and their screens clean without the risk of damage. The chemical compatibility between cleaning and disinfecting agents and the materials of modern medical devices is now being more thoroughly researched to provide better solutions for tomorrow’s doctors and patients. And while there is not yet any national standard on the presence and use of many of the touchscreen devices that have entered the environment of care, many care facilities have already developed and integrated their own protocols for the handling of these devices. And many medical professionals have called out for the national standards they feel will be an important tool in the fight against HAIs.

    1 Centers for Disease Control and Prevention. (2016, March).

     
     

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