Healthcare-Associated Infections

Orlando Fuentes Marrero, Celica

McKinnon, Janee Saliba, & Denise Thai
 Objectives
● Understand the goals and vision of Health People
● Develop an understanding of Healthcare-Associated Infections
(HAIs) and learn about common types of HAIs
● Explore how HAIs affect individuals, families, communities, and
age groups throughout the lifespan
● Familiarize yourself with ways to prevent HAIs
● Acknowledge the health disparities of HAIs
● Learn about community and website resources available for HAIs
● Introduce the Centers for Disease Control and Prevention
 About Healthy People
Healthy People offers 10-year science-based, nationwide objectives for
optimizing the health of all Americans.
Overarching Goals of Healthy People:
● Attain high-quality, longer lives free of “ A society in which all people
preventable disease, disability, injury, and
premature death live long, healthy lives.”
● Achieve health equity, eliminate disparities,
and improve the health of all groups
● Create social and physical environments that
promote good health for all
● Promote quality of life, healthy development,
and healthy behaviors across all life stages

(Office of Disease Prevention and Health Promotion, 2018)

 Healthcare-Associated Infections (HAIs)
HAIs are infections that patient get while receiving High-Priority objectives addressed by Healthy People 2020
treatment for medical or surgical conditions ● Central Line-Associated Bloodstream Infection
(CLABSI)
● Many HAIs are preventable ○ Serious HAIs that happen when germs enter
● Infections can be associated with procedures and the bloodstream through a central line
devices used in medical procedures ● Methicillin-Resistant Staphylococcus aureus Infection
● HAIs occur in all types of care settings (MRSA)
○ MRSA can cause life-threatening
Common types of HAIs bloodstream infections, pneumonia, and
surgical site infections
● Catheter-associated urinary tract infections (CAUTI)
● Surgical site infections
● Bloodstream infections
● Pneumonia
“At any one time in the US, 1 out of 25
● Clostridium difficile hospitalized patients are affected by an HAI.”

(Office of Disease Prevention and Health Promotion, 2018)

 Why is it Important?
● The behavior of health care providers and their interactions with the health care
system can influence the HAIs rate
○ Proper education and training increase compliance with and adoption of best practices to
prevent HAIs
● HAIs are one of the most significant sources of complications that can be
transmitted between health care facilities around the continuum of care
○ Studies show that there can be up to a 70% reduction in certain HAIs when existing
prevention practices are implemented
■ Medical Cost Savings
Healthy People 2020 reflects the commitment of the US Department of Health and Human
Services in preventing HAIs.
(Office of Disease Prevention and Health Promotion, 2018)
Healthcare-Associated Infections & Individuals
● HAIs affect individuals
○ Increasing patient suffering
○ Can lead to permanent disability
○ Prolongs hospital stays
○ Increase the need for a higher level of care
○ Raise medical costs for patients and the hospitals
● Avoid HAIs!
○ Wash your hands often
○ Take care of yourself
■ Eat right, exercise, quit smoking, and avoid stress
○ Speak up
■ Talk with your healthcare provider if you have questions or concerns
Healthcare-Associated Infections & The Community
● HAIs affect communities
○ Increases the spread of infection
○ An infection contracted outside of a healthcare setting or an
infection that is present upon admission is considered a
community-acquired infection
● Community-Acquired Infections are distinguishable
○ By the type of organism that affect patients recovering from a
disease or injury
● MRSA is an important pathogen associated with both HAIs
and community-acquired infections
Healthcare-Associated Infections & The Lifespan
● Acquiring an HAI throughout one’s lifespan may be practically inevitable
○ Patients can be better educated on how to protect themselves by using
resources
■ They should fully understand the treatment plans and expected outcomes
● Routine health and wellness visits while practicing proper hygiene
techniques to prevent opportunistic organisms can affect one’s health
throughout their lifespan
Healthcare-Associated Infections & Families
● Assess the knowledge and necessary teachings for the family
○ Vital for preventing patients from being at a higher risk of HAIs
and communicable diseases
■ Practice proper hygiene and aseptic techniques while
caring for an immunocompromised loved one
■ Covering your mouth and nose when coughing or sneezing
in addition to frequent hand washing
■ Thorough hand washing after using the toilet or touching
soiled surfaces
■ Providing home foods that are prepared properly, i.e.,
preventing cross contamination and proper temperature
storage
■ Restricting visits from family/visitors that are ill
 Hand Hygiene
● Hand hygiene is considered the most effective method of preventing HAIs
○ Unfortunately, it is poorly performed by health care workers (Gould, Drey, Moralejo, Grimshaw, & Chudleigh, 2008)
■ Proper training and technique can improve the performance of hand hygiene and prevent HAIs
■ Teaching health care workers and people about hand hygiene helps them and their communities stay healthy
● Hand hygiene prevents illnesses and spread of infections to others
○ Utilizing soap removes germs from hands that can be transferred to other objects and then transferred to another
person’s hand (Centers for Disease Control and Prevention, 2015)
■ People frequently touch their eyes, nose, and mouth without realizing and germs can get into the body through
these sources
● Hand hygiene helps battle the rise of antibiotic resistance
○ By preventing sickness, people reduce the amount of antibiotics prescribed and the likelihood of antibiotic resistance
(Centers for Disease Control and Prevention, 2015)
■ Frequent hand washing helps prevent the overuse of antibiotics, reducing the number of antibiotic resistant
infections and prevents people from getting sick with germs that are already antibiotic-resistant
 Antimicrobial Stewardship
● Antimicrobial Stewardship is a program that promotes the
appropriate use of antimicrobials, including antibiotics
○ Antibiotic-resistant bacteria can make infections harder to treat
■ Helps improve patient outcomes
■ Decreases the spread of infections caused by
multidrug-resistant organism
■ Involves a multidisciplinary approach
● Physicians, Pharmacy, Nurses, Microbiologists,
Infection Control, Information Services, etc.
■ Accomplished by obtaining cultures before starting
necessary antibiotics and using the results to reassess the
continued need for antibiotics

(Weiner et al., 2016)

Roadmap to Elimination
● National Action Plan to prevent HAIs: Roadmap to
Elimination
○ Contains strategies on preventing HAIs
■ Within acute care hospital settings, ambulatory surgical
centers, end-stage renal disease facilities, and long-term care
facilities
○ For increasing influenza coverage of healthcare personnel
○ Supports further research on how to identify and control HAIs
■ Applies evidence-based approaches for reducing HAIs
○ Helps implement antimicrobial stewardship to further prevent HAIs

(Office of Disease Prevention and Health Promotion, 2018)

 Healthy Disparity
● Healthcare-Acquired Infections can affect all ages,
races, and genders
○ Little is known about racial and ethnic disparities in the
occurrence of HAIs
● The following highlights were based on socioeconomic
context, comorbidities, and multiple on present
admission factors
○ Blacks are hospitalized with bloodstream infections
more often than Whites
○ Hispanics are hospitalized with urinary tract infections
more often than Whites
○ Enhanced ambulatory care can reduce racial/ethnic
differences in infections
 Community Resources
Agency for Healthcare Research &
Quality (AHRQ)
Consumers Advancing Patient
● Invests in research and evidence to Safety (CAPS)
make health care safer and improve
quality ● Provides guidelines for Infection
● Generates, measures, and analyzes Control by engaging patients and
data used to track and improve families that lead to measurable
performance and evaluate progress improvements in safety and quality
of the U.S. Health System
 Website Resources
● Professionals
○ AHRQ Morbidity & Mortality Rounds
■ Searchable online journal and
forum on patient safety and
healthcare, including the topic of
HAIs
● Clients
○ AHRQ Patient Safety Network
■ National web-based resource that
posts news and resources on
patient safety, including HAIs
● Additional Website Resources
○ Professionals
■ American Hospital Association
■ American Health Quality Association
■ Association for Professionals in Infection Control
and Epidemiology
○ Clients
■ Consumers Advancing Patient Safety
■ Food and Drug Administration
■ National Institute of Allergy and Infectious Diseases
 Centers for Disease Control and Prevention
Centers for Disease Control and Prevention Mission
● Centers for Disease Control and Prevention (CDC) works 24/7 to protect America from health,
safety, and security threats, both foreign and in the U.S. CDC fights disease and supports
communities and citizens to do the same
Centers for Disease Control and Prevention’s Role
● Detecting and responding to new and emerging health threats
● Tackling the biggest health problems causing death and disability for
Americans
● Putting science and advanced technology into action to prevent disease
● Promoting healthy and safe behaviors, communities and environment
● Developing leaders and training the public health workforce, including disease
detectives
● Taking the health pulse of our nation

(Centers for Disease Control and Prevention, 2014)

References
Centers for Disease Control and Prevention (2014). Mission, role, and pledge. Retrieved from
https://www.cdc.gov/about/organization/mission.htm

Centers for Disease Control and Prevention (2015). Show me the science - Why wash your hands?. Retrieved from
https://www.cdc.gov/handwashing/why-handwashing.html

Gould, D.J., Drey, N.S., Moralejo, D., Grimshaw, J., & Chudleigh, J. (2008). Interventions to improve hand hygiene compliance in patient care.
JOURNAL OF HOSPITAL INFECTION, (3). 193.

Office of Disease Prevention and Health Promotion (2018). About healthy people. Retrieved from
https://www.healthypeople.gov/2020/About-Healthy-People

Office of Disease Prevention and Health Promotion (2018). Healthcare-associated infections. Retrieved from
https://www.healthypeople.gov/2020/topics-objectives/topic/healthcare-associated-infections

Office of Disease Prevention and Health Promotion (2018). National action plan to prevent health care-associated infections: Roadmap to elimination.
Retrieved from https://health.gov/hcq/prevent-hai-action-plan.asp

Weiner, L. M., Fridkin, S. K., Aponte-Torres, Z., Avery, L., Coffin, N., Dudeck, M. A., & ... McDonald, L. C. (2016). Vital Signs: Preventing
Antibiotic-Resistant Infections in Hospitals - United States, 2014. MMWR: Morbidity & Mortality Weekly Report, 65(9), 235-241.
doi:10.15585/mmwr.mm6509e1