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Hospital Acquired infections and the inpatient environment

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Summary

Hospital-acquired infections (HAIs) are infections that are acquired during a hospital stay and were not present or incubating at the time of admission (Monegro et. al, 2023).

• Hospital-acquired pneumonia infections

• Infections caused by Clostridium difficile (Monegro et. al, 2023)

• Ventilator associated pneumonia

• Surgical site infections

• Central line-associated bloodstream infections

HAIs Include:

• Catheter-associated urinary tract infections

HAIs...

• Cause more deaths worldwide than malaria, tuberculosis and AIDS combined (Peters et al., 2022)• Increase morbidity, prolong hospital stay, and are a major financial burden to healthcare systems (Peters et al., 2022)

• HAIs create $124-$348 million in direct expenditures in North Carolina each year (NCDHHS, 2024)

• HAIs create $28-$33 billion in excess costs in US (NCDHHS, 2024)

• Approximately 722, 000 infections and 75,000 HAI related deaths occur each year in US (NCDHHS, 2024)

IMPACT:

• The CDC estimates that 5% of all hospital admissions result in HAI (North Carolina Department of Health and Human Services [NCDHHS], 2024)

• Environmental contamination has been significantly associated with transmission of pathogens in outbreaks of Methicillin Resistant Staphylococcus aureus, Vancomycin resistant enterococci, Clostridium difficile, and Acinetobacter baumannii (Center for Disease Control [CDC], 2024)

• There is an increase of 150-500% in the chance of acquiring a pathogen if the prior room occupant was colonized with it (CDC, 2024).

CAUSES OF HAIS:

can survive up to

can survive up to

5 months

Acinetobacter species

Klebsiella species

Some HAIs can survive on environmental surfaces for months (CDC, 2024)

30 months

•In addition to:

• We need to appropriately store patient supplies to avoid contamination

• Changing gloves in between tasks

• Using the appropriate PPE

• Disinfecting high touch surfaces

• Hand hygiene

• The proper storage of patient supplies is a Joint Commission requirement

PREVENTION:

• Studies have demonstrated that environmental hygiene interventions demonstrated a significant decrease in colonization or HAI for all microorganisms tested (Peters et al., 2022).

In response to a recent audit done in 7W inpatient rooms, you may have noticed new signage to help encourage environmental hygiene.

PREVENTION

+ info

• 38 rooms were found to have inappropriate storage of one or more supplies on the sink

Results of audit:

• 256 7W inpatient rooms were audited
• 160 audits were done on night shift
• 96 audits were done on day shift

14.8%

• 14 rooms were found to have inappropriate storage of one or more supplies on the biohazard bin

Results of audit...

5.5%

Question 1:

Question 2:

Center for Disease Control. (2024, March 19). Healthcare-sssociated infections (HAIs).https://www.cdc.gov/healthcare-associated-infections/hcp/cleaning-global/introduction.html Monegro, A.F., Muppidi, V., & Regunath, H. (2023). Hospital-acquired infections. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK441857/North Carolina Department of Health and Human Services. (2024, January 22). Healthcare-associated infections: Facts and Figures. https://epi.dph.ncdhhs.gov/cd/hai/figures.htmlPeters, A., Schmid, M.N., Parneix, P., Lebowitz, D., de Kraker, M., Sauser, J., Zingg, W., & Pittet, D. (2022). Impact of environmental hygiene interventions on healthcare-associated infections and patient colonization: a systematic review. Antimicrobial Resistance & Infection Control, 11 (38). https://doi.org/10.1186/s13756-022-01075-1

REFERENCES

THANK YOU FOR YOUR TIME AND FOR YOUR EFFORTS IN INFECTION PREVENTION!

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