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.

Hospitals 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 hospitals 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.

System Changes Affecting Healthcare Facility Safety Webinar

The Institute for Healthcare Improvement (IHI), The Centers for Disease Control and Prevention (CDC), and Avaris Concepts are pleased to announce an upcoming 90-minute webinar for healthcare leadership to promote the development and adoption of strategies and tools to promote engagement in initiatives to prevent healthcare-associated infections (HAI). To learn more and to register, please click here.

LEARNING PROGRAM: ANTIBIOTIC STEWARDSHIP

A multi-part educational program on Antibiotic Stewardship in Acute Care Hospitals has been scheduled for this fall. The program consists of a one-day conference (Sept. 14 in Shrewsbury), with pre- and post-session audio conferences (Sept. 7 and Nov. TBD, respectively), as well as pre-meeting readings. It's sponsored by DPH and the Massachusetts Coalition for the Prevention of Medical Errors, in association with Tufts Medical Center, UMass Memorial Medical Center, Brigham and Women's Hospital and the Alliance for the Prudent Use of Antibiotics. Enroll a hospital team; the cost is $80 per person. To learn more and to register, go to the Coalition's website.

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 health care 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 health care 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 health care 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 Hospitals


For 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.

The World Health Organization's initiative "SAVE LIVES: Clean Your Hands"

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.

• 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.

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