What is a Healthcare Acquired Infection?
Healthcare Acquired Infections
Healthcare-associated infections (HCAI’s) can develop either as a direct result of healthcare interventions such as medical or surgical treatment through contaminated hands, clothing or equipment, or from being in contact with harmful bacteria coming from a healthcare setting e.g. contaminated water splashIng from a tap.
According to the 2012 Health Protection Agency operations guidance and standards:
The term HCAI covers a wide range of infections. The most well-known include Legionella, Pseudomonas aeruginosa, Cryptosporidium, meticillin-resistant Staphylococcus aureus (MRSA), meticillin-sensitive Staphylococcus aureus (MSSA), Clostridium difficile (C.diff) and Escherichia coli (E. coli). Almost all pathogens associated with HCAI’s are water-born and originate this way. They are transmitted in ways such as by touch through poor or infrequent handwashing, water splashing onto sterile equipment, clothing or patient beds which then comes into contact with patients and from airborne water (aerosol) which is breathed-in by patients.
HCAI’s cover any infection contracted:
• as a direct result of treatment in, or contact with, a health or social care setting
• as a direct result of healthcare delivery in the community
• as a result of an infection originally acquired outside a healthcare setting (for example, in the community) and brought into a healthcare setting by patients, staff or visitors and transmitted to others within that setting (for example, norovirus).
HCAIs pose a serious risk to patients, clients, staff and visitors to health and social care premises. They can incur significant costs for the NHS and others, and cause significant morbidity and mortality for those infected. In addition, those people who do survive often experience life changing on-going health issues throughout their life.
Numbers Infected
According to the National Institute for Health and Care Excellence (NICE) It is estimated that 300,000 patients a year in England acquire a HCAI as a result of care within the NHS. The most common types of healthcare- associated infection are respiratory infections (including pneumonia and infections of the lower respiratory tract) (22.8%), urinary tract infections (17.2%) and surgical site infections (15.7%).
Dr. Paul McDermott a leading Microbiologist and water-borne pathogen expert stated:
"It is commonly recognised that water outlets such as taps and showers can harbour harmful bacteria and can easily transmit this to vulnerable patients - so handwash stations now need to be treated as medical devices rather than just sanitary ware"
The cost of HCAI’s in the UK
The NHS states that 1 in 26 inpatients will contract a HCAI. However, some published figures show the percentage at 6% or more.
NHS inpatient average stay is published as being 3.5 days but this increases to 21 days+ if a patient contracts a HCAI. At a cost of £400 per day per patient, these increased costs are highly significant.
Also special costly antibiotics are needed to try to tackle such infections as those from Legionella bacteria or Pseudomonas.
These costs together with growing litigation costs and the high levels of activity required to keep water systems safe produce a cost of HCAI’s to in excess of £40m per hospital per year.
Jim Shannon MP said:
"UK healthcare-associated infections cost lives and money. Some 300,000 healthcare-associated infections every year cost the NHS in excess of £1 billion annually. If we could encourage Government to roll out their strategy to reduce hospital infections and to publish their staff hand hygiene indicator, that would give us a methodology whereby we could do that. We look forward to the Government’s response on that"