Health Care Acquired Infections

Summary

According to the Centers for Disease Control (CDC), each year, U.S. hospitals experience 1.7 million health-care associated infections (HAIs), causing roughly 99,000 deaths at a cost of $37 to $45 billion. However, hospitals are making strides to reduce, and in some cases eliminate, HAIs. In addition, the Patient Protection and Affordable Care Act of 2010 (ACA) and the American Recovery and Reinvestment Act of 2009 (ACA) both include several provisions aimed at reducing HAIs, including financial penalties for providers with high HAI rates and increased measurement and reporting of HAIs.

Health care acquired infections (HAIs), also known as nosocomial infections, are infections that patients acquire 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. 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. Other risk factors include long hospital stays, the use of indwelling catheters, failure of health care workers to wash their hands and overuse of antibiotics, according to Healthline.

In American hospitals alone, the CDC estimates that health care-associated infections account for an estimated 1.7 million infections and 99,000 associated deaths each year. Of these infections:

• 32 percent of all healthcare-associated infection are urinary tract infections
• 22 percent are surgical site infections
• 15 percent are pneumonia (lung infections)
• 14 percent are bloodstream infections

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 health care expenditures.

Many HAIs can be prevented through the strict adherence to evidence-based best practices. Recommendations include:

• health care 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.

To ensure health care providers are adhering to the guidelines, monitoring of performance is critical for determining the effectiveness of quality improvement interventions. Performance can be evaluated through outcome measures (for example, the rate of occurrence of MRSA per 1,000 patient days) or process measures (for example, the percent of patient encounters in compliance with hand hygiene procedure).

Increasingly, states are mandating public reporting of hospital infection rates as an incentive for health care facilities to improve care and enable consumers to choose safer care. Twenty-six states now require public reporting of hospital infection rates.