Infections: An Unpleasant Bonus of Your Hospital Stay?
When you enter a hospital for surgery or other procedure, you expect that the ones taking care of you will do everything they can to keep you well. Yet, the Centers for Disease Control and Prevention (CDC) estimates that hospital-acquired infections (HAIs), account for approximately 1.7 million infections and 99,000 deaths every year. That translates into a one in 17 chance of dying from an HAI—fairly unpleasant odds.
Of course, some of these infections could not possibly have been prevented. After all, a lot of people who go into the hospital are pretty sick, or dying. But at least one-third, and likely more, of all hospital-acquired infections can be prevented. Many of them occur because of simple precautions that are not followed by health care professionals. HAIs cost the U.S. between $5 and $10 billion annually in health care dollars.
The question of microbes is a serious one, because the costs and the stakes are high. If you acquire an infection after surgery, you will spend, on average, nearly an extra week in the hospital—6.5 days, to be exact. You will also be five times more likely to be readmitted to the hospital, and will be twice as likely to die. Additionally, surgical patients with HAIs are 60 percent more likely to be sent to the ICU. And none of this accounts for your additional pain and suffering, and your family’s worry.
Most HAIs (over 80 percent) fall into one of four categories:
- Catheter-associated urinary tract infection (CAUTI). Accounting for 32 percent of all infections, the risk of CAUTI increases the longer you have a catheter inserted.
- Surgical site infection (SSI). Approximately 22 percent of all infections are SSIs. They arise largely from non-sterile practices or operating environments.
- Ventilator-associated pneumonia (VAP). Pneumonia accounts for 15 percent of infections, and is often caused by ventilator equipment that was not thoroughly sterilized.
- Central line-associated bloodstream infection (CLABSI, also known as CR-BSI). Bloodstream infections account for 14 percent of all infections, and are a serious risk of any long-term catheter placement, such as for dialysis or chemotherapy.
All infections become deadly serious if the infecting microbe has significant antibiotic resistance. One example is methicillin-resistant Staphylococcus aureus (MRSA), an increasing cause of VAP. Attention is being focused on preventing its transmission, and also the transmission of Clostridium difficile, a bacterium often caught by those who have had inappropriate antibiotic usage. C. difficile causes severe, sometimes life-threatening, diarrhea.
Prevention Saves Lives and Money
HAIs are not inevitable. Health care professionals can take several precautions that will help prevent them:
- The simplest precaution is the washing of hands before and after seeing each and every patient. An estimated 40 percent of infections are caused by inattention to this practice. Likewise, clean protective clothing and gloves also minimize risks. Direct contact is the most common way that microbes are transmitted in HAIs.
- The cleaning of the site on the patient where a procedure must be done, or a catheter must be inserted, to prevent transmission of microbes inside the body, especially into the bloodstream.
- The removal of all catheters at the earliest time possible. The chance of infection grows with each day one is left in place.
- The careful use of antibiotics postoperatively can prevent infections as well, but their usage must be monitored.
- The proper cleaning of ventilator equipment, and the proper positioning of the patient so they are not lying flat, will help prevent VAP.
- The isolation of patients with antibiotic-resistant infections, or gram-negative bacterial infections, from the rest of the hospital patient population.
Hospital Law in South Carolina
In South Carolina, the General Assembly passed a law in 2006 that requires the reporting of HAIs from selected procedures to the South Carolina Department of Health and Environmental Control (DHEC). For a hospital to be licensed to perform the procedures, they must comply with the Hospital Infections Disclosure Act (HIDA) reporting procedures. Surgical site infections, ventilator-assisted pneumonia, and central line bloodstream infections are among the infections that must be reported.
How You Can Protect Yourself
Remember that infections are not limited to hospitals. They can also occur in clinics, dialysis centers, and long-term care facilities.
Speaking up may be required. If you are shy about doing so, or are too sick to do so, you need someone with you who will ask questions about the following issues:
- If you have a central line or urinary catheter, ask every day if it is still necessary.
- If a health care professional comes to see you, before they touch you, if you did not see them clean their hands, ask them to do so in front of you.
- Ask about safe injection practices. The same syringe should never be used on more than one patient, even with a new needle.
- Ask if the appropriate tests will be done to determine the correct antibiotic when you need one.
- Point out any symptoms of infection, such as redness, swelling, or discharge at the surgical, IV, or catheter site. Mention pain and fever as well.
- Tell a nurse or doctor if you have more than three episodes of diarrhea in 24 hours, especially if you have been on an antibiotic. You could have a Clostridium difficile infection.