Hospital Acquired Infections: Detection and Management

Hospital-Acquired Infections (HAIs) or “nosocomial” infections are infections commonly contracted by patients while receiving treatment at healthcare facilities. These can include hospitals, nursing homes, ambulances, rehabilitation centers, surgical centers, and clinics. HAIs may also be contracted from other healthcare professionals. 

Typically, an HAI impact the lungs, skin, urinary tracts, digestive tracks or enters the bloodstream. The most common Hospital-Acquired Infection include urinary tract infections, surgical site infections, ventilator-associated pneumonia, and bloodstream infections.

HAIs are not always easy to treat, and they may affect a patient for a long time to come. Their occurrence can potentially prove dangerous and sometimes even prove fatal for patients. Hence, the optimal approach to reducing HAIs is prevention more than cure. 

What the Statistics Say

HAIs cause prolonged illnesses resulting in life-long disabilities, extended hospital stays, higher mortality rates, a greater financial burden on families, and growing stress on healthcare ecosystems. In developing nations like India, the occurrence of HAIs is much higher. According to the World Health Organization (WHO):

• For every 100 hospitalized patients, 7 in developed nations and 10 in developing nations will acquire at least one HAI at some point. 
• A urinary tract infection is the most frequent HAI is in high-income countries. On the other hand, a surgical site infection is a leading infection in settings with limited resources. It affects up to one-third of operated patients, which is nine times higher than in developed countries.
• In low and middle-income countries, the frequency of ICU-acquired infection is at least two to threefold higher than in high-income countries. 
• Newborn babies are at increased risk especially in developing countries, with infection rates three to 20 times higher than in high-income countries. 

Top Factors Putting Patients at Risk of Contracting HAIs

Several factors contribute to increased susceptibility to HAIs, especially in large-scale healthcare facilities such as hospitals. These include: 

• Poor hygienic conditions and waste disposal systems
• Absence of guidelines and policies
• Prolonged and incorrect use of invasive devices and antibiotics
• Insufficient application of standard isolation precautions
• Poor infrastructure and insufficient equipment
• Understaffing and overcrowding of facilities
• Poor knowledge and application of basic infection control measures
• Inadequate adherence to procedures and protocols

Most of these problems can be addressed through comprehensive management and execution of basic hygiene protocols at healthcare facilities. 

Preventing Hospital-Acquired Infections

Controlling the spread of HAIs must be a top priority for healthcare facilities today, especially as the number of patients keeps growing. The safety of patients, healthcare professionals, employees, caregivers, and visitors, must be prioritized especially as facilities scale. This is an achievable goal if safety protocols are designed and implemented, with commitment. Here are the key steps healthcare facilities must take to contain the spread of HAIs:   

• Develop comprehensive policies for maintaining hygiene: Robust hygiene across healthcare premises is a basic cornerstone for preventing HAIs from spreading. Healthcare facilities need a comprehensive, systematic approach that covers all areas, from cafeterias and washrooms to patient wards and ICUs. A lack of hygiene in even one area enables HAIs to spread quickly. 
• Create cleaning schedules for optimal hygiene: Healthcare facilities need to take a scientific approach to ensure that all areas are kept clean, at all times. This includes beds, floors, reception areas, and emergency rooms. 
• Empower hospital staff to disinfect frequently touched surfaces: Disinfecting frequently touched surfaces is one of the most important practices. Yet, most people are unaware of how to do it, or how often it is to be done. Educating the staff on how to quickly disinfect such areas in real-time and encouraging them to do it at regular intervals, is a welcome step. 
• Educate employees and visitors about hygiene practices: Educating them via posters and other media about dos and don’ts such as wearing masks, gloves, and washing hands, goes a long way. 
• Introduce best hygiene practices in kitchens: Large-scale healthcare facilities, especially, produce tonnes of food every day – from patient meals to snacks for staff and visitors. Kitchens can quickly turn into breeding grounds for HAIs if strict hygiene protocols are not followed. 
• Introduce laundry management schedules: Ensuring that patients have access to clean sheets and other types of clean linen, is an important aspect of the overall hygiene protocols. 
• Invest in smart devices, IoT systems: Leveraging technology and smart tools help cement compliance to all hygiene protocols. They enable staff to respond in real-time to needs such as spot cleaning and unexpected accidents. 
• Install washbasins and sanitizers at regular intervals: For instance, it’s a well-established fact that hands are a major pathway to infection, but according to UNICEF, 40 % of healthcare facilities in India are not equipped to practice hand hygiene at all points of care. Despite the obvious need for basic resources such as washbasins at healthcare facilities, they tend to be in short supply even today. Sanitizers must also be placed at common junctures, from entrances and reception areas to doctor’s rooms and other spaces, with high footfalls. 

Conclusion

Healthcare hygiene management and its role in thwarting the rise of HAIs plays an important role in improving the health care index of any country. Healthcare facilities can also consider getting professional interventions to ensure that cleanliness and hygiene are maintained with the highest standards. Tried-and-tested methods management systems are available, but the playbook keeps evolving to keep pace with technology and new challenges faced by the healthcare sector.