Unexpected Complications: The Phenomenon of Healthcare-Associated Infections Part I: Overview of the Issue

The ultimate irony is going to the hospital to be cured of an ailment and instead contracting a potentially lethal infection. Unfortunately, this is a reality for approximately one out of every 25 currently hospitalized patients in the U.S., or 650,000 patients annually.[1] Health care-associated infections (HAIs) are some of the most common complications of hospital care, and though prevention measures have been on the rise in recent years, HAIs still result in tens of thousands of lives lost and billions of dollars spent each year.[2] Though there are many different kinds of HAIs, their causes are similar and typically preventable, so it is important to have some fundamental facts when determining whether or not a client has been wronged.

The next few articles will provide an in-depth analysis for specific types of HAIs, but this initial post will focus on the basics. Want to know when and why they occur? Read on!

 

What are HAIs?

Many medical and surgical procedures require invasive devices, and while the intent of these instruments is to treat patients, they can also carry diseases and cause infections.[3] Sometimes these infections are viral – such as hepatitis, influenza, norovirus, or HIV – and sometimes they’re bacterial – such as tuberculosis, pneumonia, MRSA, or urinary tract infections.[4] Infections associated with specific indwelling devices (ventilators, catheters, and central lines) and surgical site infections account for approximately half of all HAIs.[5]

 

Where do they occur?

HAIs happen in many different kinds of care settings. Though initial assumptions may imply otherwise, HAIs can occur in outpatient care, long-term care facilities, ambulatory surgical centers, dialysis facilities, and acute care hospitals.[6]

 

Why do they occur?

Viral infections can be spread due to unsafe or unsanitary injection processes, but the most frequent HAIs – those associated with indwelling devices – are of a more complicated nature.[7] A central line-associated bloodstream infection occurs when bacteria enter the bloodstream through a tube placed in a large vein emptying out near the heart.[8] With ventilator-associated pneumonia, endotracheal intubation allows bacteria to travel straight into a patient’s lungs.[9] Bacteria are also led right to the source in catheter-associate urinary tract infections. Essentially, indwelling devices provide direct access to systems bacteria can affect most strongly.

 

What are the larger consequences of HAIs?

Besides the danger they post to individual patients, HAIs can be transmitted between different health care facilities, and even between medical staff members.[10] Because proper HAI prevention education and training are relatively simplistic, it is a reflection on the inferior state of many U.S. hospitals that HAIs are still such a serious problem.[11]

 

In the next article, the details of one of the most dangerous and common types of healthcare-associated infections will be examined: surgical site infections.

[1] “Health Care-Associated Infections,” Patient Safety Network, July 2016, https://psnet.ahrq.gov/primers/primer/7/health-care-associated-infections

[2] Ibid

[3] “Healthcare-Associated Infections,” HealthyPeople.gov, n.d., https://www.healthypeople.gov/2020/topics-objectives/topic/healthcare-associated-infections

[4] “Healthcare-associated Infections; Diseases and Organisms in Healthcare Settings,” Centers for Disease Control and Prevention, March 26, 2014, https://www.cdc.gov/hai/organisms/organisms.html

[5] “Health Care-Associated Infections,” Patient Safety Network

[6] “Healthcare-Associated Infections,” HealthyPeople.gov

[7] “Healthcare-associated Infections: Diseases and Organisms”

[8] “Healthcare-Associated Infections,” HealthyPeople.gov

[9] Tedja, Rudy and Steven Gordon, “Hospital-Acquired, Health Care-Associated, and Ventilator-Associated Pneumonia,” Cleveland Clinic Center for Continuing Education, Nov. 2013, http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/infectious-disease/health-care-associated-pneumonia/

[10] “Healthcare-Associated Infections,” HealthyPeople.gov

[11] Ibid