Healthcare-associated+Infections

**Healthcare-associated Infections:**

Healthcare-associated infections (HAI) are defined as:  A localized or systematic condition that (1) results from an adverse reaction to the presence of an infectious agent(s) or its toxin(s), (2) that occurs during a hospital admission, (3) for which there is no evidence the infection was present or incubating at admission, and (4) meets body site-specific criteria” (Klevens, 2007). HAI occur in a variety of healthcare settings including “acute care within hospitals, same day surgical centers, ambulatory outpatient care in health care clinics, and long-term care facilities” ("Healthcare-associated infections," 2012). Healthcare-associated infections can lead to extended hospital visits, increased medical costs, and a significant cause of morbidity and mortality ("Healthcare-associated infections," 2012). According to the Centers for Disease Control and Prevention, there are five types of healthcare-associated infections ("Type of healthcare-associated," 2011):


 * 1) Central line-associated bloodstream infection (CLABSI)
 * 2) //Clostridium difficile// infection (//C. diff, C. difficile//, CDAD)
 * 3) Surgical site infection (SSI)
 * 4) Catheter-associated urinary tract infection (CAUTI)
 * 5) Ventilator-associated pneumonia (VAP)

Risk factors for healthcare-associated infections include medical procedures, antibiotic use, administrative factors, and patient medical histories ("Healthcare-associated infections," 2012). Factors that increase the risk of contracting an HAI include, “Use and maintenance of medical devices, such as catheters and ventilators, complications following surgical procedures, transmission between patients and health care workers, contaminated air conditioning systems, disproportionate nurse-to-patient ratio, physical layout of the health care facility” ("Healthcare-associated infections," 2012). Simple methods to reduce the risk of contracting HAIs include proper education and training of healthcare workers in adopting careful use of antibiotics, antimicrobial drugs, sanitation and sterilization methods, and basic infection control practices ("Healthcare-associated infections," 2012).



**The Impact of Healthcare-associated Infections:**

A 2002 estimate states approximately 17 million infections and 99,000 deaths can be attributed to healthcare associated infections in the United States ("AHRQ's efforts to," 2009). This number of HAIs, “exceeds the number of cases of any other notifiable disease, and the number of deaths associated with HAIs in hospitals outnumbers deaths associated with the tops ten leading causes of death reported in the U.S. vital statistics” (Klevens, 2007). Financial burden to HAI is estimated between $28 and 33 billion each year ("AHRQ's efforts to," 2009). Approximately 9.4% of inpatient costs in the United States are due to healthcare-associated infections ("Healthcare associated infections:," 2009). More than 69% of healthcare-associated infections affect individuals enrolled in Medicare or Medicaid programs and can increase a hospital stay by 17.6 days ("Healthcare associated infections:," 2009).

Based on statistics obtained from the U.S. Bureau of Labor Statistics, the Centers for Disease Control and Prevention has developed estimates for the total annual costs of HAI-associated healthcare costs. Approximately $3.2 to 8.6 billion are spent on surgical site infections (Scott II, 2009). Urinary tract infections have an annual cost of approximately $340 to 370 million dollars each year (Scott II, 2009). Central line associated bloodstream infections range from $590 million to 2.68 billion, ventilator-associated pneumonia cost between $780 million to $1.5 billion, and approximately $1.01 billion to 1.62 billion is spent on treating Clostridium difficile-associated disease each year (Scott II, 2009).



Approximately 58.9% of healthcare facilities in Kentucky report at on at least one healthcare-associated infection to the Centers for Disease Control’s National Healthcare Safety Network (NHSN) (“Kentucky activities to”, 2011). The state health department is involved with a Comprehensive Unit-based Safety Program (CUSP) initiative and has established a state plan titled, “[|Kentucky State and Regional Infection Prevention and Epidemiology Program (K-STRIPE) Healthcare Associated Infections Prevention Plan]” to address healthcare-associated infections (“Kentucky activities to”, 2011). The state has received the 2009-2011 Recovery Act funding for the amount of $276,125 for the basic staffing, coordinating, and establishment of an HAI prevention plan “Kentucky activities to”, 2011). In 2011, Kentucky was also awarded the Affordable Care Act (ACA) for the funding amount of $274,784 to establish an HAI Prevention Infrastructure and HAI Prevention Initiative (“Kentucky Activities to”, 2011).

<span style="font-family: 'Times New Roman',Times,serif;">**Healthcare-associated Infection Advocacy Campaigns:** <span style="border-bottom-width: 0px; border-color: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; cursor: pointer; font-family: 'Times New Roman',Times,serif; font-size: 90%; height: 325px; padding-bottom: 4px; padding-left: 4px; padding-right: 4px; padding-top: 4px; width: 218px;">

“Save Lives: Clean Your Hands” is an annual global campaign launched in 2009 by the World Health Organization. It was established as a worldwide effort to support healthcare workers to improve hand hygiene in heath care and reduce the risk of healthcare-associated infections. “Save Lives: Clean Your Hands” is an extension of WHO Patient Safety First Global Patient Safety Challenge. The initiative “Clean Care is Safer Care” is aimed at reducing healthcare-associated infections and was launched in October 2005 (“Clean Care is”, 2011).

“Save Lives: Clean Your Hands” incorporates a global annual day on May 5. This campaign stresses the importance of hand hygiene in healthcare with educational tools for support from the World Health Organization. These tools include instructional videos, posters, and template action plans for healthcare-based groups to easily develop action plans in the workplace. Currently, 124 ministers of health worldwide have pledged commitment to reducing healthcare-associated infections and support the World Health Organization initiative (“Clean Care is”, 2011). Forty-three Countries have started the hand hygiene programs (“Clean Care is”, 2011).

<span style="font-family: 'Times New Roman',Times,serif;">**Contact Information for Local, State, and National Health Organizations:**

<span style="font-family: 'Times New Roman',Times,serif;">The Louisville Metro Department of Health and Wellness provides services and support for public health issues such as healthcare-associated infections through partnerships with agencies such as the U.S. Department of Health and Human Services and the Kentucky Cabinet for Health Services. The health department may be contact via phone at (502)-574-6520 8am-5pm or by mail at Administration Building, 400 East Gray Street, Louisville, KY 40202 ("Homepage- health and," 2012).

<span style="font-family: 'Times New Roman',Times,serif;">The Kentucky state contact responsible for healthcare associated infections is Fontaine Sands DrPH, MSN, CIC. Dr. Sands is the HAI Program Manager of the Infectious Disease Branch in the Division of Epidemiology at the Kentucky Department for Public Health. She can be contacted via email at Fontaine.Sands@ky.gov or via phone at the number (502)-564-3261 ext. 4129 ("Kentucky activities to," 2011).

<span style="font-family: 'Times New Roman',Times,serif;">The U.S. national agency responsible for healthcare-associate infection prevention, monitoring, and research is the Centers for Disease Control. The CDC may be contacted by mail at Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta, GA 30333, via phone at 1-800-CDC-INFO (232-4636) 8am-8pm Monday-Friday, or by email at cdcinfo@cdc.gov ("Healthcare-associated infections," 2011).

<span style="font-family: 'Times New Roman',Times,serif;">**References** <span style="font-family: 'Times New Roman',Times,serif;">(2009). //Healthcare associated infections: The unknown killer//. (2009). [Web Photo]. Retrieved from http://files.visualization.geblogs.com/visualization/files/2011/07/JESS3_GE_HA _Infographic_18.jpg

<span style="font-family: 'Times New Roman',Times,serif;">(2011). //Clostridium difficile infection//. (2011). [Print Photo]. Retrieved from http://ecdc.europa.eu/en/healthtopics/clostridium_difficile_infection/PublishingIages/clostridium.jpg

<span style="font-family: 'Times New Roman',Times,serif;">(2011). //Healthcare-associated infections (HAIs)//. (2011). [Print Photo]. Retrieved from http://www.cdc.gov/HAI/infectionTypes.html

<span style="font-family: 'Times New Roman',Times,serif;">(2011). //Why skin prep matters//. (2011). [Print Photo]. Retrieved from http://www.chloraprep.co.uk/whySkinPrepMatters.html

(2011). //Your 5 moments for hand hygiene//. (2011). [Print Photo]. Retrieved from http://www.who.int/gpsc/5may/Your_5_Moments_For_Hand_Hygiene_Poster.pdf

"Clean Care is Safer Care." //World Health Organization//. World Health Organization, 2011. Web. 10 Feb 2012. <http://www.who.int/gpsc/5may/background/en/>.

<span style="font-family: 'Times New Roman',Times,serif;">//Healthcare-associated infections//. (2012, January 10). Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=17

<span style="font-family: 'Times New Roman',Times,serif;">//Healthcare-associated infections- HAI//. (2011, November 02). Retrieved from http://www.cdc.gov/hai/

<span style="font-family: 'Times New Roman',Times,serif;">//Homepage- health and wellness-louisvilleky.gov//. (2012). Retrieved from http://www.louisvilleky.gov/Health/

<span style="font-family: 'Times New Roman',Times,serif;">//Kentucky activities to prevent healthcare-associated infections//. (2011, August 15). Retrieved from http://www.cdc.gov/HAI/stateplans/state-hai-plans/ky.html

<span style="font-family: 'Times New Roman',Times,serif;">Kentucky Department for Public Health, Kentucky State and Regional Infection Prevention and Epidemiology Program (K-STRIPE) (2011). //Healthcare associated infections prevention plan//. Retrieved from Kentucky Department for Public Health website: http://chfs.ky.gov/dph/epi/hai/stateplan.htm

<span style="font-family: 'Times New Roman',Times,serif;">Klevens, R. M., Edwards, J. R., Richards, C. L., Horan, T. C., Gaynes, R. P., Pollock, D.A., & Cardo, D. M. (January 01, 2007). Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002. Public Health Reports Us, 122, 2, 160-166.

<span style="font-family: 'Times New Roman',Times,serif;">Mukhopadhyay, C. (Photographer). (2008). //Ventilator-associated pneumonia with col-sstrains: a successful comeback of colistin!//. [Print Photo]. Retrieved from http://www.scielo.br/scielo.php?pid=S1413 86702008000500018&script=sci_arttext

<span style="font-family: 'Times New Roman',Times,serif;">Scott II, R. D. Centers for Disease Control and Prevention, Division of Healthcare Quality Promotion (2009). //The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention//. Retrieved from Centers for Disease Control and Prevention website: http://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf

<span style="font-family: 'Times New Roman',Times,serif;">//Type of healthcare-associated infections//. (2011, March 21). Retrieved from http://www.cdc.gov/HAI/infectionTypes.html

<span style="font-family: 'Times New Roman',Times,serif;">U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality. (2009). //AHRQ's efforts to prevent and reduce healthcare-associated infections// (Publication No. 09-P013). Retrieved