You are admitted at the hospital to get better however medical errors, such as healthcare associated infections, aka nosomomical infections may occur.
Whether you will develop a HAI depends your overall health and resilience as well as the institution itself. The average chance you will acquire such an infection in a hospital or healthcare facility is not exactly clear. Some sources state 1 in 9 people get infections while others talk about 1 in 25.
In the United States, it has been estimated that 9.2 out of every 100 patients acquire a nosocomial infection (Jarvis, et al., 1991).
This equates to about 1.7 million Americans each year being infected in hospitals, ambulatory clinics, surgical centers, dialysis units, and long-term care facilities such as rehabilitation centers and nursing homes.
Who are at risk?
Patients with weakened immune systems due to illness or invasive medical treatment are easily infected. When you are immunocompromised, your body is less able to control infections on its own.
The elderly, young children (newborns), and long-stay patients are also at greater risk. The latter especially when antibiotics are overused or when cathethers are left in place longer than necessary.
Which is why on the ICU the risk on getting an infection is higher.
Up to 20.6 percent of ICU patients acquire nosocomial infections during or after their stay, (European Prevalence of Infection in Intensive Care Study, 1995)
The most common types of HAI
Of the most common types of infections acquired at healthcare facilities,
- about one third are urinary tract infections (Catheter Associated Urinary Tract Infections (CAUTI)
- roughly one fifth are surgical site infections
- somewhat less frequently occuring are lung infections (Ventilator-Associated Pneumonia (VAP))
- and of about the same magnitude are bloodstream infections
Another type of nosocomial infections are pressure ulcers also referred to as bed sores and Clostridium difficile infections.
What are the risks?
Patients with a hospital acquired infection typically stay in the hospital 2.5 times longer than those who are not infected. What’s worse is that your chances on dying increase considerably once you’ve got a HAI.
Chances on being admitted to ICU after surgery increase and you are more likely to be readmitted to the hospital after discharge.
In 2002 it was known that almost 99,000 patients die each year in the US alone due to hospital aquired infections (which is another definition of the abbreviation).
According to the CDC,
HAIs in hospitals are a significant cause of morbidity and mortality in the United States
Most of the estimated 98,987 deaths associated with HAIs in U.S.hospitals were due to pneumonia and bloodstream infections.
How to reduce your risks and prevent nosomomical infections
According to the CDC, most of the 2 million HAI that occur yearly are preventable. Prevention practices carried out by the healthcare institution cover the most of these incidences. For instance by reducing overcrowding and poor infection control practices.
There are however several things you can do to reduce your risk on incurring a HAI while getting medical treatment.
Key is to take an active stance, to be an proactive patient and take matters into your own hands while recovering. According to studies, the following measures help avoid development of these infections. Be aware of those aspects and ask your medical personnel to comply.
- Don’t be afraid to ask the nurses and doctors to wash their hands or wear gloves. Insist on hand washing. If you do feel hesitant, remember that medical staff move from patient to patient thus they themselves often are the vessel for spreading pathogens.
According to the WHO, about 40 percent of HAIs are caused by poor hand hygiene. This number can be reduced greatly if medical personnel makes an habit out of regular and frequent hand washing and wearing protective garments such as aprons and gloves when working with patients.
You could make a neon posterboard sign with a friendly request for caregivers to please wash their hands before touching you. Tape the sign above the bed or at another prominent place.
- Research shows that one of the main reasons handwashing isn’t done as often as is desirable is the lack of available sinks and the fact that hand washing takes time. To combat this you could place an alcohol-based hand rub on your bedside table. By facilitating the staff you can save them time and you may feel less embarrassed about asking them to wash their hands.
Pay attention to proper carrying out of environmental desinfection.
- Ask health care providers to sanitize anything you will be in contact with. By using antiseptic wipes on surfaces intended to be part of your care germs can be kept at bay. From the doctor’s or nurse’s stethoscope, catheters, to a new IV bag, make sure these are desinfected before applied.
- Ask other personnel and visitors to do the same. Everybody, from visitors to cleaning staff and people who bring the food, can introduce germs into your environment. As a rule, everything that is touched by other people should be wiped or sprayed afterwards.
- If needed, make sure to sanitize your environment yourself as much as possible. Use antiseptic wipes and sprays to fight off germs on touch surfaces in your hospital room such as call buttons, light switches, TV remotes, telephones, bathroom surfaces, touch plates, bed rails, chairs, beside table, counter and table tops, intravenous poles, door handles, grab rails, dressing trolleys, and dispensers (soap, paper towel, alcohol gel). Wipes with hydrogen peroxide or bleach are more effective than those containing alcohol.
Studies show that especially those surfaces in closest proximity of patients are known to be contaminated with VRE, MRSA, and Staphylococcus.
Interpersonal prevention measures
- Cough and sneeze in your elbow, not in your hands. When someone in your surroundings (i.e. visitor, room mate, nurse) is coughing wear a germ-filtering mask. If you have someone bring these from the local pharmacy make sure to wipe or spray the package before you open it.
- Visitors should keep their distance. Of course visitors should wash their hands before touching you too. Apart from that, tell them not to kiss you and not to sit on your bed or touch your bed rails. You are vulnerable and although such personal contact is well-meant it’s risky. Nosomomical infections are serious , potentially lethal, health conditions not to be taken lightly. Make sure your visitors are informed before they will come to see you. For example by appointing a contact person who takes care of notifying other visitors. Which brings us to the next advice.
- Bring a personal advocate. Get a friend or relative to speak up for you and ensure proper care is given to you when you are not able to do so yourself. For instance when you are too tired, unconscious, or otherwise incapacitated.
Questions to ask your medical personnel
- Do I still need to use a catheter? Leaving a catheter or infusion in for too long can cause infection. If you suspect symptoms of an infection are occuring ask if you still need the catheter or infusion.
- Do you think I may have a C.diff infection? If you have diarrhea, and especially when taking antibiotics, ask your doctor if you may have Clostridium difficile (C. diff) infection. This condition is known to affect hospital and long term care patients and causes infectious diarrhea linked to 14,000 American deaths each year. According to the this particular HAI still occurs “at historically high levels“.
Recognize nosomomical infection symptoms
Which symptoms occur depends on the types of infection. Symptoms commonly include inflammation, abscesses, fever and discharge. You may experience irritation, itch, or pain at the infection site as well as visible symptoms.
- Know the signs and symptoms of an infection. Some skin infections such as MRSA appear as redness, pain or drainage at a surgery or catheter site often accompanied by fever. Tell your doctor about these symptoms.
Be Careful In your use of antibiotics
- Help prevent antibiotic resistance by taking your medication exactly as prescribed. Don’t stop treatment a few days early because you’re feeling better. Ask for tests to be done in order to confirm the apropriate type of antibiotic is prescribed.
A personal note on speaking up regarding infection prevention and your care in general.
When I was in the hospital I noticed that after a few days the infusion site on my arm started to irritate. It felt uncomfortable (more than before), the skin turned a little red, raised and troubled. It seemed inflammation was occurring. At that point I had already asked the day before when the infusion could be taken out. They said they would ask the doctor but the day after when I asked again they still had to ask the doctor. I then urged them to take it out asap which was done the day after. I’m no doctor but sometimes you just know when to be proactive and stand up for yourself. The point being, try to be alert at your situation at all times. Or have someone to do so for you.