Jordan Ellis
Nosocomial infections, also known as hospital-acquired infections (HAIs), are illnesses that patients can contract while receiving treatment in a healthcare facility. They are associated with medical devices, surgical procedures, antibiotic overuse, and transmission between patients and healthcare workers. HAIs can cause serious health complications, prolonged hospital stays, and even death. While some HAIs are unavoidable, many can be prevented through diligent infection control measures, such as frequent hand hygiene, adherence to sterile techniques, and proper antibiotic use. This paragraph introduces the topic of preventing hospital-acquired infections, specifically in the UK context, and highlights the importance of proactive measures to safeguard patient health and reduce the burden of HAIs.
| Characteristics | Values |
|---|---|
| Type of infection | Nosocomial, healthcare-associated, or hospital-acquired infections (HAIs) |
| Cause | Infectious diseases caused by bacteria, viruses, fungi, or parasites |
| Place of infection | Infections acquired in a hospital or another healthcare setting |
| Time of infection | Must develop at least 48 hours after admission |
| Risk factors | Low immunity, extended hospital stays, surgical procedures, inadequate hand hygiene |
| Prevention methods | Hand hygiene, infection control procedures, appropriate antibiotic use, sterile techniques |
| Impact | Increased hospital stays, distress, morbidity, mortality, and healthcare costs |
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What You'll Learn
Surgical site infections
Some types of surgery carry a higher risk of infection than others due to the varying levels of risk from different types of germs. For example, infections are more likely to occur after surgery on parts of the body that naturally have a lot of germs, such as the gut.
To prevent surgical site infections, doctors and nurses will try to lower the risk of infection before, during, and after surgery. They might ask you to shower with soap and water or clean yourself with an antibacterial solution before your operation. They may also check if you have any antibiotic-resistant bacteria, such as MRSA or carbapenem-resistant organisms.
After surgery, your nurse will regularly check your wound for any signs of infection. If they suspect an infection, they may take a swab sample from the surface of your wound. It is important to treat any infection as soon as possible to prevent it from worsening.
Once you leave the hospital, the medical team may monitor your wound remotely by asking you to send regular updates, including photos of your wound and details about its healing process. They will reply to your submissions and contact you if they need more information. This service helps you manage your wound at home and reduces the risk of wound infection.
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Ventilator-associated pneumonia
To prevent VAP, it is recommended that patients who smoke quit smoking before receiving treatment involving a ventilator. This is because smoking increases the likelihood of developing infections. Patients should also ask healthcare providers about their hand hygiene practices and request that they clean their hands before any physical contact or equipment use. Additionally, enquire about the frequency of oral care, as proper oral hygiene can reduce the risk of bacteria entering the lungs.
Another preventative measure is to ask about the positioning of the bed. Raising the head of the bed can help prevent VAP by improving lung function and reducing the risk of aspiration. Patients should also ask about breathing trials and the possibility of breathing without a ventilator, as this can reduce the risk of VAP.
Furthermore, healthcare providers should adhere to Core Infection Prevention and Control Practices to minimise the spread of germs. Acute care hospitals should implement strategies to prevent VAP, and treatment typically involves antibiotics. However, the specific type of antibiotic depends on the bacteria causing the infection. High-flow nasal oxygen or non-invasive positive pressure ventilation (NIPPV) can also be utilised to prevent intubation or reintubation, reducing the risk of VAP.
While not all hospital-acquired infections can be prevented, these measures significantly reduce the risk of VAP. Patients should also practise good hand hygiene and ensure any necessary medical devices, such as catheters, are regularly reviewed.
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Catheter-associated urinary tract infections
Nosocomial infections, also known as healthcare-associated infections (HAIs) or hospital-acquired infections, are illnesses that develop while receiving treatment in a healthcare facility. These infections can range from mild to life-threatening and, in some cases, can lead to serious complications or even death. Urinary tract infections (UTIs) associated with catheter use are a type of HAI that can be prevented through proper catheter usage, insertion, and maintenance. Here are some strategies to prevent catheter-associated UTIs:
Proper Catheter Usage:
Healthcare providers should adhere to guidelines and best practices for catheter insertion and maintenance. The 2009 CDC Guideline for Prevention of Catheter-associated Urinary Tract Infections (CAUTIs) provides detailed recommendations for proper catheter usage in various healthcare settings. Acute care hospitals should refer to the latest updates and strategies specific to their settings.
Infection Prevention Protocols:
Healthcare facilities should implement infection prevention protocols to reduce the transmission of pathogens. This includes frequent hand hygiene, which is crucial in limiting the spread of germs. Proper handwashing techniques and the use of alcohol-based hand sanitizers are essential components of hand hygiene.
Monitoring and Assessment:
Hospitals can monitor CAUTI rates through systems such as the CDC's National Healthcare Safety Network (NHSN). This allows facilities to assess the effectiveness of their prevention efforts and identify areas for improvement. By utilising tools like the Targeted Assessment for Prevention (TAP) Strategy, facilities can address specific infection prevention gaps and implement tailored interventions to reduce CAUTI risk.
Patient Involvement:
Patients can play an active role in preventing catheter-associated UTIs. It is recommended to ask healthcare providers about their infection control procedures and whether catheterisation is still necessary each day. Additionally, patients should follow instructions for antibiotic use and ensure proper antibiotic prescriptions through appropriate testing.
Antibiotic Stewardship:
Appropriate antibiotic use is crucial in preventing catheter-associated UTIs. Antibiotics are typically used to treat UTIs, but excessive or improper use can contribute to antibiotic resistance. Patients should take antibiotics exactly as prescribed and only when advised by their healthcare provider. Healthcare providers should also ensure proper antibiotic prescribing practices through diagnostic testing.
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Hand hygiene
For patients, it is important to wash your hands frequently, especially after using the toilet and before eating. You can use soap and running water, or an alcohol-based hand sanitiser. Don't be afraid to ask nursing or medical staff if they have cleaned their hands before touching you.
For healthcare workers, hand hygiene is crucial before and after every patient interaction. This includes washing hands with soap and water or using an alcohol-based hand rub. It is essential to pay attention to proper handwashing techniques, ensuring that the hands are thoroughly cleaned, including the palms, backs of hands, between fingers, and under nails.
In addition to handwashing, other measures can be taken to ensure effective hand hygiene. This includes the use of gloves, particularly when handling infectious materials or performing invasive procedures. Gloves should be changed between patients and in case of any contamination. Hand hygiene should also be practised after removing gloves, as the hands can still be contaminated even if gloves are worn.
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Antibiotic overuse
Antibiotics have been one of the greatest innovations of the 20th century, paving the way for major advances in cancer treatment, organ transplantation, and surgery. However, their overuse has become one of the biggest threats to modern medicine. Antibiotic overuse has resulted in the emergence of "superbugs", or strains of bacteria that have developed resistance to many different types of antibiotics. These include MRSA (methicillin-resistant Staphylococcus aureus), Clostridium difficile (C. diff), and the bacteria that cause multi-drug-resistant tuberculosis. The overuse of antibiotics in hospitals is particularly concerning because hospitals are breeding grounds for drug-resistant bacteria.
In the UK, it is estimated that 80-90% of antibiotics are prescribed for oral use in primary care, with half of these prescriptions being for respiratory tract infections and one-sixth for urinary tract infections. A survey of antibiotic prescribing in UK general practice found that half of all patients consulting for coughs, colds, and viral sore throats were prescribed antibiotics, even though professional guidance does not recommend this. This variation in prescribing practices suggests that there is scope for safely reducing antimicrobial use in the UK.
To address antibiotic overuse, it is important to follow guidance from organisations such as the Royal College of General Practitioners (RCGP) on when and which antibiotics to prescribe. Doctors should also feel empowered to educate their patients about the appropriate use of antibiotics and the risks of antibiotic resistance. Patients, on the other hand, should not expect or pressure their doctors to prescribe antibiotics unnecessarily and should take antibiotics only as prescribed.
Additionally, it is important to be cautious when buying antibiotics abroad or over the internet. Antibiotics should only be taken when prescribed by a doctor, and leftover antibiotics from a previous prescription should not be used without consulting a doctor first. It is also important to remember that infections often take longer to resolve than we expect, and getting worse before getting better is typical of many viral infections.
By addressing antibiotic overuse, we can help preserve the effectiveness of these life-saving medications and reduce the spread of drug-resistant bacteria in hospitals and the community.
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Frequently asked questions
Hospital-acquired infections, also known as healthcare-associated infections (HAIs) or nosocomial infections, are illnesses that patients can catch while receiving treatment in a healthcare facility.
HAIs are quite common, with an estimated 3.5 million cases occurring in the EU and European Economic Area (EEA) annually. In the US, about 99,000 people die from HAIs each year.
HAIs are often caused by invasive procedures, improper antibiotic use, and inadequate infection control and prevention procedures. Poor hand hygiene by both staff and patients is also a contributing factor.
Patients can reduce their risk of HAIs by practising good hand hygiene, ensuring they only take antibiotics as prescribed, and speaking to their healthcare providers about infection control procedures.
Signs and symptoms of an HAI can vary depending on the type of infection but may include fever, increased mucus production, increased white blood cell count, and localised symptoms such as redness, swelling, or pain.
