HAIs: What They Are
Healthcare-acquired infections (HAIs), also known as nosocomial infections, are infections that patients get 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.
Who's At Risk
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 healthcare workers to wash their hands, and overuse of antibiotics.
In American hospitals alone, the Centers for Disease Control (CDC) estimates that HAIs account for an estimated 1.7 million infections and 99,000 associated deaths each year. Of these infections:
- 32 percent of all healthcare acquired infection are urinary tract infections
- 22 percent are surgical site infections
- 15 percent are pneumonia (lung infections)
- 14 percent are bloodstream infections
What's at Stake
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 healthcare expenditures.
What Providers Are Doing to Prevent HAIs
Recent reports have shown that many HAIs can be prevented through the strict adherence to evidence-based best practices. Recommendations include:
- healthcare 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.
Healthcare providers are making great strides to reduce, and in some cases eliminate, HAIs. In this section resources are identified and case study examples are highlighted to assist healthcare providers to improve the prevention of HAIs.
How to Protect Yourself Against HAIs
The CDC has released these example questions for patients to raise to their nurses and doctors to protect themselves from Healthcare-associated Infections.
CDC Checklist for Core Elements of Hospital Antibiotic Stewardship Programs - March, 2014
The checklist (link below) is a companion to Core Elements of Hospital Antibiotic Stewardship Programs. This checklist should be used to systematically assess key elements and actions to ensure optimal antibiotic prescribing and limit overuse and misuse of antibiotics in hospitals. CDC recommends that all hospitals implement an Antibiotic Stewardship Program.
Facilities using this checklist should involve one or more knowledgeable staff to determine if the following principles and actions to improve antibiotic use are in place. The elements in this checklist have been shown in previous studies to be helpful in improving antibiotic use though not all of the elements might be feasible in all hospitals.
Click here for checklist
CDC Antibiotic Resistance Threats in the United States -
Antibiotics Resistance Threats in the United States, 2013 is a snapshot of the complex problem of antibiotic resistance today and the potentially catastrophic consequences of inaction. The overriding purpose of this report is to increase awareness of the threat that antibiotic resistance poses and to encourage immediate action to address the threat. This document can serve as a reference for anyone looking for information about antibiotic resistance. It is specifically designed to be accessible to many audiences. For more technical information, references and links are provided.
This report covers bacteria causing severe human infections and the antibiotics used to treat those infections. In addition, Candida, a fungus that commonly causes serious illness, especially among hospital patients, is included because it, too, is showing increasing resistance to the drugs used for treatment. When discussing the pathogens included in this report, Candida will be included when referencing "bacteria" for simplicity. Also, infections caused by the bacteria Clostridium difficile (C. difficile) are also included in this report. Although C. difficile infections are not yet significantly resistant tot he drugs used to treat them, most are directly related to antibiotic use and thousands of Americans are affected each year..READ MORE
CDC Releases Infection Prevention Guide to Promote Safe Outpatient Care
According to recent findings, medical care in outpatient settings has surged in recent years, yet in many cases, adherence to standard infection prevention practices in outpatient settings is lacking. To protect patients and help educate clinicians about minimum expectations of safe care, the Centers for Disease Control and Prevention (CDC) this week released a new guide and checklist specifically for healthcare providers in outpatient care settings. The Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care is based on existing, evidence-based CDC guidelines that apply to a wide range of healthcare facilities but are mostly used by hospitals. The guide is accompanied by an infection prevention checklist for outpatient settings and supporting materials including a new, no-cost, certified continuing medical education course titled Unsafe Injection Practices: Outbreaks, Incidents, and Root Causes that is offered for clinicians in all healthcare settings. The guide also recommends that all outpatient practices should have at least one staff member with specific training in infection control. The guide and supporting materials can be used for internal assessment within a facility or practice. (CDC, press release, 7/13/11)
CDC Releases IV Catheter Infection Prevention Guidelines
The Centers for Disease Control and Prevention (CDC) just released the "Guidelines for the Prevention of Intravascular Catheter-Related Infections" that were developed for hospital, outpatient and home healthcare settings.
They provide guidance for all types of intravascular catheters for adults and pediatrics, including:
- Education, training and hand hygiene;
- Skin preparation and barriers for insertion;
- Maintenance including dressing regimens and replacement;
- Antimicrobial catheters, cuffs, flushes, locks; and
- Arterial catheters and pressure monitoring devices.
CDC - HAI reduction and implementation tool kits
The American Recovery and Reinvestment Act of 2009, Public Law 111-5 (ARRA), was signed into law on February 17, 2009. Within the Recovery Act, $50 million was authorized to support states in the prevention and reduction of healthcare-associated infections. Many of these funds are being used to support activities outlined in the HHS Action Plan to Prevent Health Care-Associated Infections. This CDC site tracks states' efforts to meet the goals of the plan and the results can be located on the CDC Healthcare-Associated Infections: Recovery Act site. CDC is assisting states in this process with implementation tool kits located at Premier's Safety Institute's Healthcare-Associated Infection Web site.
- CLABSI (Catheter-related bloodstream infection)
- CDI (Clostridium difficile infection)
- CAUTI (Catheter-related urinary tract infections)
- MRSA (Methicillin-resistant S. aureus)
- SSI (Surgical site infection
Infection Prevention: Highlights from Massachusetts HospitalsFor the past two years, the Massachusetts Coalition for the Prevention of Medical Errors (the Coalition) and the Massachusetts Hospital Association (MHA) have been offering programming to support the prevention of hospital-acquired infections throughout the Bay State.Massachusetts hospitals have made infection prevention a top priority for patient safety and quality improvement; executive and clinical leadership at 100% of acute-care hospitals have signed on to participate in this initiative. The Coalition and MHA are pleased to present a sample of the infection prevention successes from Massachusetts hospitals across the state. If you are a consumer, use this guide to see what hospitals in your area are doing to prevent hospital-acquired infections. If you are a provider, look for ideas that you can incorporate into your own infection prevention efforts.
On 5 May 2010 this initiative celebrated its second year of global action, inviting hospitals and health-care facilities throughout the world to take part in a global initiative, to continue to raise hand hygiene awareness, to move action to the point of care, and to reduce health care-associated infection (HAI). Be part of a global movement to improve hand hygiene.
The World Health Organization's initiative "SAVE LIVES: Clean Your Hands"
- Join the network of countries that already have hand hygiene campaigns operating.
- Help fight HAI in your country.
- Use the WHO tools and resources to improve hand hygiene compliance and have access to other updates and resources from WHO Patient Safety.
- Share your knowledge and successes with others.
- Make patient safety Your No 1 priority.