Healthcare Acquired Infections (HAIs)

Healthcare Acquired Infections Name Institutional Affiliation Healthcare Acquired Infections Healthcare Acquired Infections (HAIs), which can also be referred to as hospital-acquired infections or nosocomial infections, refer to infections that patients acquire in the process of getting treatment for either a medical or a surgical condition (ODPHP, 2019). Normally, during admission, the infection is not present. The modern medical practice uses different types of invasive procedures and devices such as ventilators and catheters in the treatment. These procedures and devices are the major causes of HAIs (Hensley & Monson, 2015). HAIs occur in various types of settings such as acute care hospitals, dialysis facilities, outpatient centers, ambulatory surgical centers, long-term care facilities, among others (Cullen & Thomas, 2018). However, surgical site infections, catheter-associated urinary tract infections, bloodstream infections, and pneumonia are the commonest HAIs. Though most HAIs are preventable, they are major causes of mortality and morbidity around the world. They also lead to increased costs of health care (Rahmqvist, Samuelsson, Bastami, & Rutberg, 2016). HAIs also include occupational infections affecting the staff. To address these challenges, there is a need to come up with strategies that focus on improving quality of care through minimizing the occurrence of HAIs. This paper seeks to look at the magnitude of HAIs, define the best practices in regard to the issue, and discuss strategies for improving the quality of care. The Magnitude of HAIs Despite the efforts to eliminate the challenge of HAIs, no country has completely solved the problem. According to the WHO, HAIs affects hundreds of millions of patients globally every year. The burden of the issue is greater in the low as well as middle-income countries. On a daily basis, HAIs result in a prolonged stay in hospitals increased resistance to antibiotics, long-term disabilities, additional health care costs, the financial burden to the patients as well as their families, and many unnecessary deaths. A study carried out in Greece revealed that the mortality risk of patients with HAIs was increased by 80%. Antimicrobial resistance also increased the risk of 90-day mortality by 90%-110% (Kritsotakis et al., 2017). However, the real global burden of HAIs remains unknown due to difficulties in gathering information. Moreover, most countries do not have adequate surveillance systems for HAIs in place. The countries that have the systems struggle with the complexity as well as lack of uniform criteria for diagnosing HAIs (World Health Organization, 2019). In the US, 1.7 million cases of HAIs are reported and lead to more than 90,000 deaths (Mauger, Marbella, Pines, Chopra, & Black, 2014). Australia lacks a surveillance system for HAIs. Therefore, assessing and determining the real burden of HAIs in the country is difficult. The effects of the initiatives adopted to enhance national infection prevention can also not be accurately assessed (Russo, Cheng, Richards, Graves, & Hall, 2015). A systematic review of peer-reviewed articles found out that approximately 83,096 HAIs occur every year. Of these cases, 71,186 were UTIs, 4902 were Clostridium difficile infections, and 3946 were surgical site infections. 1962 acute stroke patients developed respiratory infections and 1100 cases of hospital-acquired bacteremia were also reported. However, the researchers acknowledged that the data was a huge underestimate because there was no data on common HAIs such as pneumonia. Therefore, 50-60% of HAIs might have been left out. Putting this into consideration, the incidence of HAIs in the country might be as high as 165,000 cases every year (Mitchell, Shaban, MacBeth, Wood, & Russo, 2017). There is, therefore, a need to address this issue since research has shown that as much as 70% of HAIs can be prevented. It is also estimated that interventions can lead to savings of between $25 and $31.5 billion (ODPHP, 2019). Best Practice As discussed earlier, HAIs cannot be ignored in the pursuit of quality health care. They affect the safety of the patient by leading to higher rates of deaths that could have been prevented as well as prolonged hospitalizations. To address this challenge various countries have come up with measures to control infection within the clinical setting. These measures include the identification of patients at the risk of HAIs, promoting hand hygiene, observing the standard precautions aimed at reducing transmission, as well as the promotion of strategies aimed at reducing specific HAIs. There is also a need to emphasize the architectural layout of the health care settings as well as other environmental factors (Mehta et al., 2014). The general measures of HAI control include isolation, identification of the type of isolating, antibiotic prophylaxis, removal of necrotic tissue, general surveillance, among others. The patients should also be categorized in accordance with their needs and risks. For instance, transplant recipients are at a higher risk and hence surveillance should be prioritized in this population. The measures can be divided into process measures, outcome measures, and balancing measures. Outcome measures help to check whether the changes adopted lead to improvement. Process measures are the changes taken in order to improve the outcomes. Balancing measures ensure that changes in one part of the system do not hurt another part (Institute for Healthcare Improvement, 2019). The best practices for surveillance of HAIs can effectively lead to a reduction in the occurrence of HIAs. Surveillance involves detection and monitoring, identification of risk factors for HIAs, evaluation of preventive interventions, as well as the provision of information aimed at educating and reinforcing the practice. Assessment of the population under survey is the first step during the establishment of a surveillance system. It helps in setting the priorities and allocation of resources to various populations based on their needs. The outcomes of surveillance should then be selected. Reduction of frequency of occurrence of HIAs, the fatality of infections, as well as the costs can be used as the surveillance outcomes. Once established, the surveillance system should be periodically evaluated to determine its efficiency and effectiveness. Studies have shown a clear outcome on the decline in the rates of occurrence of HAIs after implementation of a surveillance program (PIDAC, 2014). Strategies for Improving Quality of Care The previous discussion has revealed the prevalence and impact of HAIs to the safety of the patient. It has also been established that most of HAIs can be easily prevented by adopting the discussed best practices. This part of the paper will dwell on the strategies that can be adopted to improve the quality of care through the reduction of HAIs. Though efforts have been made by various countries to address HIAs, rising levels of antimicrobial resistance (AMR) have impeded any significant progress. Therefore, the fight against HIAs should go hand in hand with the fight against AMR. This can be achieved through enhanced antimicrobial stewardship and adoption of evidence-based antimicrobial use. Other measures that can help address the high rates of HIAs include greater investment in hand hygiene, as well as the development of standard prescribing guidelines (Fernando, Gray, & Gottlieb, 2017). The strategy adopted depends...