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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).

HAIs Include:

• Catheter-associated urinary tract infections

• Central line-associated bloodstream infections

• Surgical site infections

• Ventilator associated pneumonia

• Hospital-acquired pneumonia infections

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

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)

IMPACT:

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

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

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

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

CAUSES OF HAIS:

• 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).

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

Klebsiella species

can survive up to

30 months

Acinetobacter species

can survive up to

5 months

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 addition to:

• Hand hygiene

• Disinfecting high touch surfaces

• Using the appropriate PPE

• Changing gloves in between tasks

• We need to appropriately store patient supplies to avoid contamination

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

PREVENTION

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

+ info

Results of audit:

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

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

14.8%

Results of audit...

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

5.5%

Question 1:

Question 2:

REFERENCES

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

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

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