No one wants to go to the hospital, and certainly no one wants to get sicker while they are there. However, since there are germs lurking throughout hospitals, there is actually a pretty good chance a patient could acquire a serious hospital infection. How common are hospital-acquired infections? Common enough that you should care. How serious are these infections? Serious, sometimes even deadly. Since these infections are common and potentially life-threatening, it’s important to know how patients can protect themselves from hospital infections.
How common are healthcare-acquired infections?
The US Centers for Disease Control and Prevention (CDC) report that on any given day, about 1 in 31 hospital patients has at least one healthcare-associated infection (HAI). Encouragingly, a survey found that patients in 2015 were at least 16% less likely to have a healthcare-acquired infection than patients in 2011. However, this is still a dangerous, common problem. The CDC report states that:
- 3% of hospitalized patients in the 2015 survey had one or more HAI.
- There were an estimated 687,000 HAIs in U.S. acute care hospitals in 2015.
- Approximately 72,000 hospital patients with HAIs died in 2015 during their hospitalizations.
How do patients get infections?
There are many ways patients develop infections. The most common healthcare-acquired infections are as follows, with the percent of overall healthcare-acquired infections given for each type:
- 25.6% – device associated infections (e.g. catheter infections in the bloodstream or urinary tract, ventilator-associated pneumonia)
- 21.8% – pneumonia
- 21.8% – surgical-site infections
- 17.1% – gastrointestinal infections
What are hospitals doing about HAIs?
Because these infections are dangerous and common, hospitals are creating programs to reduce infections. And some of the programs show very promising results. A few examples of hospital efforts that have reduced infection rates:
Encouraging progress on bloodstream infections.
Research published in 2013 shows the positive impact of patient bathing and nasal cleansing (with antimicrobial soap and ointment) for all ICU patients without testing for signs of infection, a technique called “universal decolonization”. The research, conducted at 43 HCA hospitals, found that universally decolonizing all patients in the ICU reduced infections. The efforts decreased MRSA-positive infections by 37% and bloodstream infections from any type of pathogen by 44%. Interestingly, the research took place in hospitals that had already implemented national guidelines for preventing healthcare-acquired MRSA infections.
Following on the success of the ICU study, researchers embarked on another study to evaluate similar strategies in non-ICU patients. This research, published in 2019, found that nasal cleansing and patient bathing with antimicrobial solutions significantly improved the infection rate for patients with medical devices such as catheters and drains. For these patients, there was a 30% decrease in bloodstream infections, and an almost 40% reduction for antibiotic-resistant bacteria, including MRSA. There was no significant difference in infection rates among the general hospital population. However, patients with devices have a high risk for bacterial infections: 37% of all MRSA cases and over 50% of bloodstream infections are in patients with devices. Therefore, reducing the risk for these vulnerable patients is a huge step forward.
Following bathing instructions pre-surgery can reduce infections.
Since surgical-site infections can occur when there are bacteria on the patients’ skin before operations, surgical patients are instructed to diligently wash the impacted body part with antimicrobial soap for a specific amount of time before they arrive at the hospital for their surgery. But patients do not always use the right soap or wash for as long as required, putting themselves at risk. A new program at Dignity Health in California provides a kit with soap, a timer and a shower card with instructions. Preliminary results indicate the program is helping reduce surgical-site infection rates.
Toothbrushing reduced pneumonia rates!
A VA hospital in Virginia researched the impact of toothbrushing. The study found that when patients brushed their teeth twice/day, there was a 92% reduction in hospital-acquired pneumonia cases (for patients who were not on ventilators). The researchers note that although this seems like a very simple mandate to implement, there are some barriers in hospitals, including:
- Hospital staff often feel that toothbrushing and other oral care is not an essential task, but is an optional daily care activity for a patient’s comfort.
- The quality of toothbrushes and other oral care supplies at hospitals is often poorly designed or in limited supply.
One of the most important things you can do as a patient or family caregiver is to make sure all medical personnel wash their hands before touching the patient, or any medical instrument. In healthcare settings, “handwashing can prevent potentially fatal infections from spreading from patient to patient and from patient to healthcare worker and vice-versa”.
A 2009 study stated that hand hygiene is the single most important factor to prevent health care-acquired infections. This article also stated that health professionals are only washing their hands 50% of the time. Don’t be shy about asking your doctor, or other staff member, to wash their hands and/or put on new gloves. Your health, and even your life, could depend on it!
Additionally, patients, family members and guests should frequently wash their own hands as well.
What else can patients do to reduce their risk of infection?
There are many steps that patients, and family members, can take. Read my blog post on superbugs in hospitals for a detailed list of recommendations.