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AHRQ's: Healthcare-Associated Infection Program

Introduction to Healthcare- Associated Infections

Video.

Reference

CDC Streaming Health. (2014, March 26). Healthcare-Associated infections in the United States. Retrieved March 29, 2021, from https://www.youtube.com/watch?v=-FfMCv8FUXI

Introduction and Clinical Problem

Can travel through many pathogens: bacterial, viral or fungal.

Seen in many different care facilities.

Risk factors: elderly, longer hospital stays, medical comorbidities, invasive devices, antimicrobial use.

Nosocomial infections can lead to increased healthcare costs, morbidity and mortality.

AHRQ’S Healthcare- Associated Infection Program was the topic our group was assigned. These infections can be of bacterial, fungal or viral origin and can be found in all sorts of facilities. Whether it be nursing homes or hospitals, this preventable situation can come to light. Hospital acquired infections (HAI) are defined as being acquired during the healthcare process but not seen upon admission. They are more prevalent in the elderly population, those staying long-term in the hospital, patients with medical comorbidities and clients with invasive devices such as a urinary catheter.

Reference

Sikora, A. (2021, February 10). Nosocomial Infections. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK559312/.

Did you know?

Slide

Key Points: CAUTI

Catheter Associated Urinary Tract Infection (CAUTI) has one of the highest healthcare acquired infections (HAI) rates.

Accounts for 80% of HAI’s in critical care settings.

The incidence rate was at 3% to 10% a day in 2018.

Urinary catheters should only be used when medically necessary, and removed immediately when no longer required.

Risks that pose the developed for CAUTI are improper sterile technique upon insertion, prolonged catheter use, poor catheter care/cleaning, and no implementations of backflow prevention (Assadi, 2018).

A urinary catheter should only be used if there is a medical necessity, and all measures to avoid use should be implemented by the healthcare team before planning to catheterized. Medical reasons a urinary catheter may be indicated are acute urinary retention, pelvic surgery, bladder outlet obstruction, and neurogenic bladder (Assadi, 2018). Before and after manipulation of a placed catheter the nurse must perform strict handwashing as well as wear clean gloves. Any sign of break in aseptic technique, leakage, or disconnection of the catheter or the collection bag equals in immediate replacement of the urinary catheter. Sterile technique is used for catheter placement and the urinary collection must be closed and unobstructed. The collection bag must remain below hip/bladder level to prevent backflow and attached to the patient’s bed (Assadi, 2018). Proper sterile technique upon insertion and aseptic technique throughout care and cleaning of the catheter are needed for optimal results and no complication or CAUTI.

Reference

Assadi F. (2018). Strategies for Preventing Catheter-associated Urinary Tract Infections. International journal of preventive medicine, 9, 50. https://doi.org/10.4103/ijpvm.IJPVM_299_17

Key Points: Handwashing

The cause of these HAI’s are due to malpractice, improper following of protocols, and outdated sterile techniques.

The most common way to stop the spread of an infection is by following the 7 steps of handwashing.

Step 1: Wet Hands. Wet your hands and apply enough liquid soap to create a good lather. ...

Step 2: Rub Palms Together. ...

Step 3: Rub the Back of Hands. ...

Step 4: Interlink Your Fingers. ...

Step 5: Cup Your Fingers. ...

Step 6: Clean the Thumbs. ...

Step 7: Rub Palms with Your Fingers.

The most common way to prevent these healthcare acquired infections is by washing the hands properly. As we all know sometimes nurses are challenged with a high nurse to patient ratio which causes us to sometimes forget the duty of being a nurse; ensuring safety and the best quality care of our ability. To reduce these infections being spread by lack of handwashing hospitals have put sanitizing stations outside every room so that the nurse can clean their hands before entering and after entering the room.

Reference

Burton, L. (2020, June 25). Hand washing STEPS: 7 NHS Techniques. Retrieved April 14, 2021, from https://www.highspeedtraining.co.uk/hub/7-steps-of-hand-washing-poster/

Nursing Management

Universal precaution rules (PPE)

Effective hand washing

Avoid urinary catheterization when possible

Proper wound care

Disinfect instruments between use

Aseptic technique

Follow rules and regulations

Safety!

Nurses have a responsibility to their communities to practice proper techniques to prevent and manage HAIs. As patient advocates, nurses hold the position to change and improve patient care standards. It is important nurses adopt a safety-minded attitude. We as nurses should treat patients responsibly and take action to prevent HAIs from happening in our communities.

Reference

Rn.com. (n.d.). Retrieved April 11, 2021, from https://www.rn.com/nursing-news/nurses-role-in-preventing-hospital-acquired-infections/#:~:text=Under%20the%20universal%20precautions%20rule,nursing%20intervention%20to%20prevent%20infection.

Statistics

Approximately one in 31 hospitalized patients has one healthcare-associated infection (HAI).

Nearly 1.7 million infections are HAIs.

HAIs account for about 99,000 deaths yearly.

HAIs make a patient 60% more likely to be admitted to the intensive care unit.

●Most HAIs are catheter associated urinary tract infections which account for 35% of HAIs.

●Patients recovering from surgery account for about 22% of patients with HAIs.

●Contracting an HAI during recovery from surgery could cause the patient to spend nearly 7 more days in the hospital (Patient Care Link, 2020).

Reference

Patient Care Link. (2020). Healthcare-Acquired Infections (HAIs).

https://patientcarelink.org/improving-patient-care/healthcare-acquired-infections-hais/.

Healthcare-associated infections (HAIs) can be developed by patients from treatment during their stay in the hospital..

The occurrence of HAIs are in multiple settings throughout healthcare.

Bacteria, viruses, and fungi are the pathogens responsible for HAIs.

Healthcare’s most common adverse event are HAIs and affect the patients safety.

Conclusion

Healthcare-associated infections occur not only in hospitals but also ambulatory clinics, outpatient surgical centers, and long term care facilities (rehabilitation centers and nursing homes). Urinary tract infections account for 32% of HAIs (Patient Care Link, 2020). Bacteria is the most common causative pathogen but the infection prevalence of the causative microorganism greatly varies and is determined by the location of the facility, the setting, and the patient population (Sikora, 2021). Furthermore HAI’s are classified as an adverse event affecting patient safety and contribute to the mortality rate, morbidity rate, and financial hardships on patients, families, as well as the healthcare system (Sikora, 2021).

References

Patient Care Link. (2020). Healthcare-Acquired Infections (HAIs).

https://patientcarelink.org/improving-patient-care/healthcare-acquired-infections-hais/.

Sikora, A. (2021, February 10). Nosocomial Infections. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK559312/.

References

Assadi F. (2018). Strategies for Preventing Catheter-associated Urinary Tract Infections. International journal of preventive medicine, 9, 50. https://doi.org/10.4103/ijpvm.IJPVM_299_17

CDC Streaming Health. (2014, March 26). Healthcare-Associated infections in the United States. Retrieved March 29, 2021, from https://www.youtube.com/watch?v=-FfMCv8FUXI

Patient Care Link. (2020). Healthcare-Acquired Infections (HAIs). https://patientcarelink.org/improving-patient-care/healthcare-acquired-infections-hais/.

Sikora, A. (2021, February 10). Nosocomial Infections. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK559312/.