Healthy People 2020:
Prevent, Reduce, and Eliminate
HealthCare Associated
Infections (HAI) –
Why Is It Important?
Holly Dugas Hebert
Loyola University of New Orleans
Population Health Nursing: 18SNURS-G483-W51
Dr. Debra Copeland, DNS, RN
What Is a HealthCare
Associated Infection
(HAI)?
•
Also called a nosocomial infection.
•
HAIs are infections occurring in a patient during the
process of receiving care in a hospital or other health
care facility.
•
These infections were not present or incubating at the
time of admission.
•
•
Includes infections acquired in a facility that do not
appear until after discharge.
Includes occupational infections amongst health-care
workers of the facility.
General HAI Timeframe
• An infection is considered to be an HAI if it appears 48hours
after patient admission or up to 30 days after discharge.
• Standardized reporting definitions highlight the importance of
prompt and timely collection of cultures due to the patient’s
symptoms. This helps to avoid a condition being deemed as an
HAI when it was present upon admission (POA).
Types of Health Care Associated Infections
•Surgical Site Infections (SSI)
•Central Line Associated Blood Stream Infections
(CLABSI)
•Ventilator Associated Event (VAE)
•Ventilator Associated Pneumonia (VAP)
•Catheter Associated Urinary Tract Infection (CAUTI)
•Clostridium Difficile Infection: Lab Identified (CDI
LabID)
•Methicillin Resistant Staph Aureus Bacteremias: Lab
Identified (MRSA LabID)
•Pneumonia
What Can Cause an HAI to Happen?
CLABSI: when tube placed in large
vein is not put in correctly or the
insertion site is not kept clean.
CAUTI: when a urinary catheter is
not put in correctly, not kept clean,
or kept in for too long.
MRSA bacteremia: MRSA can
cause serious blood stream
infections and is usually caused by
contaminated hands.
SSI: occurs when germs get into an
area where surgery was performed;
area not kept clean, improper
wound care, improper hand
hygiene; SSIs can affect skin and
underlying organs/tissue.
What Can Cause a
patient to have a
C-Diff HAI?
•Long term use of antibiotics
•Improper hand hygiene of
staff caring for patient or the
patient themselves
•Improper cleaning of
patient care equipment
HAI Statistics:
• 30 – 40% of all HAIs are completely preventable.
• 80% of all infectious diseases are transferred by touch.
• Approximately 40% of all health-care professionals
adhere to proper hand hygiene techniques.
• 1 in 4 HAIs are caused by antibiotic resistant bacteria
(MRSA, VRE, CRE, Acinetobacter Baumannii, etc. ).
How will an HAI affect My Patient?
• 1 in 20 patients in the United States acquires an HAI.
• 1.7 million people a year acquire an HAI.
• On average, hospital length of stay extended by 17.6 days after acquiring an HAI.
• On average, additional cost to patient from an HAI is $1,100 per admission.
• 2 out of 3 Medicare/Medicaid patients will be affected by an HAI.
• High Mortality Rate associated with HAIs.
• HAIs kill more patients every year than breast and prostate cancer combined.
• 98,987 patients in the United States die annually after acquiring an HAI.
• Increased patient length of stay.
How will
an HAI
affect the
facility
where I
work?
• 9.4% of inpatient costs for a facility are related to an HAI.
• HAIs cost the health care system $35 billion per year.
• Mandatory standardized reporting of HAIs to CDC and NHSN:
CLABSI, CAUTI, MRSA bacteremias, CDI LabID events, and
SSIs from colon surgery and abdominal hysterectomies
• Transparency to the public: facility HAI rates are accessible to
the public on the Intranet. Patients can use this information to
choose where to seek health care.
• Affects reimbursement to facility (HAI = no payment)
HAI Prevention
Methods:
•
Proper Hand Hygiene
•
Involvement of trained Infection
Control Department.
•
Routine staff and patient
education.
•
Use of research based best
practice measures for central
lines/port a caths/peripheral IVs
and foley catheter insertions and
maintenance.
•
Daily assessment and care of all
invasive devices.
•
Daily reassessment of need for
invasive device use.
HAI Prevention Methods:
• Development of Antibiotic Stewardship
Team.
• Avoid overuse and improper use of
antibiotic medications.
• Prompt isolation of patients with
contagious infectious disease processes.
• Proper timing of Pre – Op clipping and
antibiotic administration.
• Routine surveillance of: hand hygiene,
isolation use, cleaning of facility and
patient care areas/equipment,
medication administration.
HAI Prevention
Methods:
• Empower the patient:
education on proper hand
hygiene, cleaning of their
medical equipment and
environment, medication
treatment regimen.
• Routine monitoring of facility
wide lab results: prompt
reporting of infectious diseases
to Public Health.
Hand Hygiene: Reasons why it is Important
• 80% of all infectious disease is spread through direct or indirect human contact.
• Hands are the most common mode for the transmission of pathogens.
• 95% of people wash their hands incorrectly.
• Hand washing reduces respiratory illness by 16%.
• Proper hand washing can prevent 1 out of 3 episodes of diarrheal illness.
Importance of HAI
Prevention Initiative
• Significant improvement of overall patient
outcomes.
•Reduction of morbidity/mortality of
patients.
•Reduction of burden of HAI cost on
health-care system.
•Increase of reimbursement by insurance
companies/Medicare/Medicaid with HAI
reduction.
•Increased patient population with
reduction of HAI due to mandatory
reporting.
• Clostridium Difficile Information for Patients (2015).
Retrieved from:
https://www.cdc.gov/hai/organisms/cdiff/cdiffpatient.html
• Healthy People 2020. Health Care Associated Infections.
Retrieved from:
https://www.healthypeople.gov/2020/topicsobjectives/topic/healthcare-associated-infections
References
• National Health Care Associated Infections Progress
(2013). Retrieved from:
https://www.cdc.gov/media/pdf/releases/2015/p011
4-mrsa-hospitals-report.html.pdf
• Quality Management (2018). Health Care Associated
Infections. Retrieved from:
http://www3.gehealthcare.com/en/Products/Categori
es/Healthcare_IT/Quality_Management