Healthcare associated infections, or HAIs, are a significant risk associated with inpatient healthcare. These infections spread in hospitals, outpatient clinics, and other healthcare facilities, and can end up making patients more ill than when they first sought treatment.
Both providers and patients should be aware of the risks associated with HAIs. Hospitalized patients are at risk of developing at least one HAI during their stay. Read on to learn more about the causes, symptoms, and prevention options for these infections, as well as when an HAI is grounds for a medical malpractice claim. The impact of HAIs on patients and the healthcare system also includes significant healthcare costs.
What are the 5 most common errors in radiology? Find out now.
A healthcare associated infection is an illness that develops while a patient receives treatment in a healthcare facility. These infections are also called nosocomial infections.
These infections can range from mild illnesses that clear up in a day, to life-threatening conditions that put patients back in the hospital. These infections spread easily in healthcare settings due to the large concentration of patients in a relatively small space.
HAIs have a major impact on both affected patients and the healthcare system as a whole. Patients may suffer serious health complications, resulting in a prolonged hospital stay and additional medical treatments. Hospitals struggle with extra costs from HAIs ranging from $28 to $45 billion.
According to the Centers for Disease Control and Prevention (CDC), on any given day, one out of every 31 hospital patients contracts an HAI. For residents of nursing homes, the rate is one in 43. Patients in surgical centers, dialysis facilities, and other settings are also at risk of HAIs. HAIs can have serious consequences, including emotional stress, financial and medical costs, prolonged hospital stays, and even death.
Nosocomial infections and iatrogenic infections are both types of HAIs, and these two terms are often confused. However, they have different meanings.
When comparing iatrogenic vs. nosocomial infections, an iatrogenic infection is caused specifically by a medical procedure. Nosocomial infections are simply infections that spread in a medical setting, but are not necessarily caused by a specific treatment. Both types of infections are associated with the delivery of medical care, where various healthcare interventions and environments can contribute to the risk of infection.
For example, you could contract a nosocomial infection just by sitting near another patient who is sick. However, an iatrogenic infection could spread if healthcare workers don’t use proper hygiene procedures when preparing for surgery or administering medication.
Healthcare associated infections (HAIs) are driven by a diverse group of pathogenic microorganisms that thrive in healthcare settings. Among the most common causative organisms are methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Clostridioides difficile (C. difficile). These bacteria and other pathogens are responsible for a wide range of associated infections, including surgical site infections, urinary tract infections, bloodstream infections, and respiratory tract infections.
The National Healthcare Safety Network (NHSN) tracks the most frequent types of HAIs, such as central line-associated bloodstream infections, catheter-associated urinary tract infections, surgical site infections, and ventilator-associated pneumonia. Each of these infections is often linked to specific causative organisms. For example, MRSA and other antimicrobial-resistant pathogens are notorious for causing surgical site infections and bloodstream infections, while C. difficile is a leading cause of gastrointestinal illness in healthcare settings.
Medical devices play a significant role in the development of HAIs. The use of urinary catheters, especially indwelling urinary catheters, increases the risk of catheter-associated urinary tract infection. Similarly, central venous catheters and central lines are major risk factors for central line-associated bloodstream infections. These devices can provide a direct pathway for bacteria like Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa to enter the body, leading to serious complications.
Certain patient populations are at higher risk for healthcare associated infections. Elderly patients, individuals with chronic conditions, and those with weakened immune systems are more susceptible to infections acquired in healthcare settings. The use of antimicrobial agents can also disrupt the body’s natural defenses, making it easier for resistant organisms to take hold.
Effective infection prevention and control measures are essential to reduce the risk of HAIs. Proper hand hygiene, the use of personal protective equipment, and strict cleaning protocols for medical devices and contaminated surfaces are all critical steps. Healthcare providers must stay vigilant, follow disease control and prevention guidelines from organizations like the Centers for Disease Control and Prevention, and educate patients about infection risks and prevention strategies.
Understanding the causative organisms behind healthcare associated infections is key to improving patient safety and healthcare outcomes. By implementing robust infection control measures and fostering a culture of awareness, healthcare workers and patients can work together to minimize the threat of HAIs and protect public health.
There are four primary types of infections: bacterial, viral, fungal, and parasitic. Some of these are more common than others in healthcare settings.
Some of the most common healthcare associated infections include:
Device-related infections, such as those involving an indwelling urinary catheter, are distinct from infections that occur after a surgical procedure. Device-related infections are linked to the presence of medical devices, while procedure-related infections, like those following surgical procedures, are associated with operative interventions and wound contamination.
Healthcare associated infections are caused by a variety of bacteria, viruses, and fungi that spread quickly in a healthcare setting. This often happens when these pathogens evolve and antimicrobial resistance develops. In this scenario, medications are no longer as effective for treating the HAI, which means they can spread faster.
Germs causing healthcare associated infections may be transmitted by direct skin-to-skin contact with other people or with contaminated surfaces. Some healthcare associated infections are spread by air when people sneeze or cough, as respiratory droplets are a primary means of transmission for certain pathogens.
Healthcare associated infections are most often spread by direct physical contact or breathing in airborne particles. Here are some of the specific risk factors for healthcare associated infections:
The exact symptoms of an HAI will depend on the specific infection present. Here are some of the most common symptoms of these infectious diseases.
To diagnose these infections, doctors will start by asking detailed questions about the patient’s symptoms and conducting a thorough physical exam. Clinical signs, along with symptoms and diagnostic tests, are used to confirm healthcare associated infections (HAIs).
If they suspect the patient has an HAI, they will order a lab test to confirm the presence of pathogenic bacteria, viruses, or fungi. Depending on the type of HAI the physician suspects, they may order blood tests, urine tests, stool tests, or sputum (phlegm) tests. With the results of these tests, doctors can recommend appropriate treatment.
Research shows that as many as 70% of HAIs could be prevented with evidence-based control methods. Here are some of the ways that providers and patients can prevent HAIs in clinical settings.
So how can surgeons help to limit nosocomial infections? Adhering to strict hygiene and patient safety protocols is key to infection control.
Surgeons, physicians, nurses, and other healthcare professionals should practice good hand hygiene at all times, even during busy periods. Many healthcare workers are already prioritizing hand hygiene, but there is room for improvement with hand washing compliance hovering around 50% at U.S. hospitals.
Surgical errors can also lead to life-threatening infections. To prevent this, surgeons should always use multiple patient identifiers to confirm their identity before starting the procedure, and mark the designated site clearly before the patient undergoes anesthesia.
Continuing education can also help providers stop the spread of HAIs. Healthcare organizations should offer regular infection prevention courses for their teams, especially those working in high-risk areas like intensive care units.
Infection control measures are crucial in preventing the spread of healthcare associated infections (HAIs). Hand hygiene is the most important practice in preventing HAIs. Healthcare workers should wash their hands with soap and water or use an alcohol-based hand rub before and after interacting with patients. This simple yet effective practice can significantly reduce the transmission of pathogens.
Sterilization of equipment and surfaces is also necessary to prevent the spread of HAIs. All medical equipment that comes into contact with body tissues or fluids must be thoroughly sterilized to kill any potential pathogens. Regular cleaning and disinfecting of patient areas, including floors, beds, doorknobs, and other surfaces, can lower the rates of HAIs.
Isolation protocols, such as placing patients with infectious diseases in private rooms, can help prevent the spread of HAIs. Healthcare facilities should have policies in place for the proper use of personal protective equipment (PPE), such as gloves and masks, to prevent the spread of infections. By adhering to these infection control measures, healthcare workers can protect patients and themselves from HAIs.
Antimicrobial stewardship is a critical component of infection control measures. It involves the appropriate use of antibiotics to prevent the development of antibiotic-resistant bacteria. Healthcare providers should only prescribe antibiotics when necessary and should choose the most effective antibiotic for the specific infection.
Healthcare facilities should have policies in place for monitoring and reporting antibiotic use and resistance. This can help prevent the spread of multidrug-resistant infections, such as methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (CDI).
Patients and their families should be educated on the risks of HAIs and the steps they can take to prevent them. When entering an inpatient facility, all patients should receive information about hygiene and medication best practices. Guide patients on how to wash their hands, when to take their medication, and how to use medical devices if they have them.
If the patient has surgery, they should receive guidance on how to change their bandages and clean the incision safely, as well as possible infection symptoms to watch for. When possible, schedule follow-up appointments to ensure the wound is healing safely.
Encourage patients to ask questions about their procedures and to report possible symptoms as soon as they arise. When communicating with patients about HAIs, be as clear and transparent as possible, and explain concepts in layman's terms rather than medical jargon.
Be honest with patients about the potential risks of HAIs in healthcare settings, and be sure to obtain informed consent whenever necessary. Patient education materials, such as brochures or fact sheets, may help address HAI concerns with patients. Physicians can also suggest reputable online resources, such as government websites like CDC.gov and MedlinePlus.gov.
Ultimately, it’s important to remember that HAIs are often preventable but present a potentially serious risk of harm to patients. Healthcare associated infections are mostly spread by direct contact with pathogens, meaning many are preventable.
By focusing on awareness and prevention, healthcare facilities can promote a culture of patient safety and reduce the threat of HAIs. Physicians should consider taking advantage of the risk management resources offered by their medical malpractice provider.
HAIs negatively impact patient outcomes, leading to an increase in medical complications, an increased mortality rate, and higher costs for healthcare providers. In the United States, around 99,000 people die from HAIs each year.
The cost of healthcare associated infections is also significant. Estimated costs range from $28 to $45 billion annually. Hospitals and insurers bear much of this cost. HAIs can also lead to longer hospital stays, which significantly increases out-of-pocket costs for patients.
Just because a patient contracts an HAI in the hospital doesn’t mean a patient has been a victim of medical negligence. Bad outcomes sometimes happen, without anyone being at fault. However, it’s useful for physicians just to be reminded about how an HAI might be grounds for a medical malpractice case.
In summary, four elements must be present:
Although like most medical malpractice claims, the physician prevails most of the time, there have been occasions where a patient has successfully pursued an HAI claim and been awarded significant judgments. For example, in 2023, a New York jury awarded a man $250,000 after finding he was mistakenly prescribed an antibiotic that caused him to develop a C. diff infection. The same year, a Michigan jury awarded almost $10 million to the estate of a woman who developed a surgical wound infection and later passed away.
Insurance helps protect physicians and other medical professionals if a patient files an HAI-related medical malpractice lawsuit. It helps cover the legal costs of defending a medical malpractice claim, including attorney, court, and expert witness fees.
Medical malpractice insurance also helps cover the costs of resolving a lawsuit. That could include the cost of an out-of-court settlement or the cost of court-awarded damages following a trial. This crucial coverage helps protect physicians’ personal finances and the finances of their practice.
Indigo is a revolutionary medical malpractice insurance provider that helps physicians get the coverage they need, at the price they deserve. With the power of AI, physicians receive pricing tailored to their practice and easy access to coverage. Physicians also enjoy access to a third-party risk management helpline to receive confidential advice about managing the risk of HAI lawsuits.
Get a quote today.
Image by fatido from iStock.
