Health Care Acquired Infections

Summary

Some reports estimate that nearly $45 billion dollars are spent yearly on health care-associated infections. The CDC estimates that 1.7 million infections cause 99,000 deaths in hospitals each year. However, hospitals are making incredible strides to reduce, and in some cases eliminate, HAIs. The following is a list of resources and case study examples highlighting hospitals as they strive to provide quality health care.

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, such as nursing homes and rehabilitation 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 are more likely to get an infection. Other risk factors are 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 [i]   

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. [ii]

• 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. [iii]

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, rate of occurrence of MRSA per 1,000 patient days) or process measures (for example, percent of patient encounters in compliance with hand hygiene procedure). 

There is a movement towards mandating public reporting of hospital infection rates as an incentive for healthcare facilities to improve care and enable consumers to choose safer care. Twenty-six states now require public reporting of hospital infection rates. [iv]