Healthcare Associated Infection is a contraction of infection within the healthcare setting while receiving treatment for a different condition. Healthcare Associated Infection is often interchangeably used with the terms nosocomial Infection.
HAI or HCAI infection is a major threat to patient safety, but easily avoidable through enhanced disinfection and patient care. Centers of Disease Control and Prevention (CDC) defines HAI as “localized or systemic condition resulting from an adverse reaction to the presence of an infectious agent(s) or its toxin(s)” (2012, Horan et al).
HAI infection is caused by infectious agents that are either endogenous sources or exogenous sources. Skin, nose, mouth, gastrointestinal (GI) tract or vagina are naturally inhabited by microorganisms and fall under endogenous sources.
Exogenous sources of healthcare-associated infection come from the environment, external to the patient. Medical Staff, medical devices, visitors, and the healthcare environment is considered exogenous sources of the infectious agent.
According to CDC, 1 in 25 hospital patient will contract one healthcare-associated Infection (HAI or HCAI) on any given day. Health-Care-Associated Infections impacts over 700,000 lives annually, and cost the government over billions of dollars (2009, R. Douglas Scott II).
There are four types of Health-Care-Associated Infections (HAI/HCAI), including Central Line-Associated Bloodstream Infections(CLABSI), Catheter-Associated Urinary Tract Infections (CAUTI), Surgical Site Infection (SSI), Ventilator-Associated Pneumonia (VAP).
Types of HAI infection:
Central Line-Associated Bloodstream Infection (CLABSI):
A central line is a catheter tube used by physicians to access a major vein that is in the vicinity of your heart to give fluids, medication or to collect blood for medical tests. Central Line-Associated Bloodstream Infections (CLABSI) is a severe infection caused by infectious agents that enter the bloodstream via the central line. Symptoms include fever, red skin, and soreness close to the central line. Thousands of patients die from CLABSI every year and cost the healthcare system billions of dollars. (https://www.cdc.gov/hai/bsi/bsi.html)
Catheter-Associated Urinary Tract Infection (CAUTI):
Urinary Catheter is a tube inserted into the bladder through the urethra to drain urine. Urinary Tract Infection (UTI) affects areas associated with urethra, bladder, ureters, and kidney. Majority of Catheter-Associated Urinary Tract Infection (CAUTI) is acquired when the urinary catheter is inserted into the bladder. Symptoms include cloudy urine, blood in the urine, pressure, pain, or discomfort in your lower back, chills, fever, vomiting, and urine leakage around your catheter. Symptoms can be hard to recognize if the patient is being hospitalized with similar symptoms of the original illness. (Ref: https://www.cdc.gov/hai/ca_uti/uti.html)
Surgical Site Infection (SSI):
Surgical Site Infection occurs after an invasive surgical procedure in the operated area. Skin infections around the surgical site can occur, or a more serious infection can occur if the tissue under the skin or organs is affected. Signs of surgical site infection include pus, drainage, pain, redness, soreness, fever, chills, obvious superficial trauma appearance (Ref: https://www.cdc.gov/hai/ssi/ssi.html)
Ventilator Associated Pneumonia (VAP):
A Ventilator is used to provide oxygen through a tube placed directly in patient’s mouth, nose, or through a hole in the front of the next. In an incident where germs associated with pneumonia enter the patient’s body through the tube and get inside, Ventilator Associated Pneumonia (VAP) occurs. Signs and Symptoms include fever, chills, cough, shortness of breath, chest pain, mucus, coughs.
Surgical Site Infection and Ventilator-Associated Pneumonia (VAP) are tied for the most common HAI infection based on HAI estimates from the US, 2011 by Centre for Disease Control and Prevention.
Incidences of HAI:
Fomite by definition is an object, material that is likely to carry infections. In a healthcare center, these can be surgical instrument including scalpels, forceps, towel clamps, ventilators, catheter, any machinery, operating bed, table, and housing patient bed itself can be formite.
Nosocomial is a term associated with originating from hospital or health care center. Nosocomial Infection applies to an infection contracted by the patient while under the medical care or while being treated for another condition in a hospital setting. Nosocomial is also synonymous with “hospital-acquired”.