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    Home Opinion Columnists Hospital Acquired Infections: A Growing Threat

    Hospital Acquired Infections: A Growing Threat

    Hospital-Acquired Infections (HAI) is a major burden on healthcare costs in our country. Such infections, also known as ‘Nosocomial Infections’, are not only dangerous but can be also deadly. Even minor infections can become a serious threat to patients. When a patient gets admitted in a hospital, he or she expects to receive the treatment to get healed.

    The patient’s family members, relatives, friends and other well-wishers desperately wait for the moment when they can take back the patients home after being successfully treated. During the course of the treatment in the hospital, all patients knit some dreams which they plan to live after getting disease-free. But unfortunately, many of the patients cannot be treated as planned and therefore cannot be discharged from the hospital at the expected time. They suffer from some infections known as the HAI which affects them physically, psychologically and also financially. The incidents of HAI are on the rise in many hospitals. Although every healthcare setups follow the guidelines for the prevention of occurrences of these infections, they have failed to protect patients from the grip of these.

    The word ‘Nosocomial’ is a combination of two Greek words. The word ‘Nous’ means disease whereas ‘Komeion’ means to take care of. Such an infection is acquired in a hospital, clinic, nursing home or any other healthcare facility. An infection is considered to be nosocomial if they appear after 48 hours or more of admission or within 30 days after the discharge from the hospital.

    In many occasions not only the patients undergoing treatment but also the attendants, workers, caregivers and other visitors become prone to HAI.  Patients might have to experience unexpected healthcare complications which enhance their stay in the hospital. When the stay in the hospital increases for a patient, it increases its cost for the treatment.

    Apart from the stay, it also adds the additional cost of medicines, foods, nursing care etc. HAI not only just adds extra costs but they can cause irreparable bodily harm and even result in death. On most of the occasions, the cause of infection or its mode of transmission cannot be detected. It is difficult to eliminate the occurrences of these infections but stress should be laid to reduce the incidences.

    The most commonly known infections are the tuberculosis, urinary tract infections (UTIs), surgical site infections, gastroenteritis, meningitis and pneumonia The common symptoms to be known are discharge from a wound, fever, cough, shortness of breathing, burning with urination or difficulty urinating, headache, nausea, vomiting, diarrhoea etc. The common causes of such infections are Staphylococcus aureus (S. aureus), Escherichia coli (E. coli), Enterococci, Pseudomonas aeruginosa (P. aeruginosa) etc. 

    The modes of transmission are various. Contact Transmission is the most important and frequent mode of transmission of nosocomial infections. It is divided into two subgroups:  Direct Transmission and Indirect Transmission.  Direct transmission involves a direct body surface to body surface contact and physical transfer of microorganism between a susceptible host and an infected person e.g. hospital worker to patient, patient to patient, patient to hospital worker or other visitors to patients or hospital workers whereas indirect transmission involves contact of a susceptible host with a contaminated intermediate object e. g. from untidy bed linens and toilet utensils, unsterile equipment and instruments, unhygienic food and water, hospital waste materials etc.

    There are other transmission like Vector-borne Transmission where infection is transmitted through insects, mosquitoes, fleas and other invertebrates’ animals, Airborne Transmission when infection is transmitted through harmful germs and microorganism present in the surrounding air, Droplet Transmission when infection is transmitted by droplet generated by sneezing, coughing etc and Common Vehicle Transmission where infection is transmitted indirectly by materials contaminated with the infections.

    The practice of active hand washing should be the cornerstone of reducing HAI. Wash hands with liquid soap and water vigorously for at least 20 seconds. Along with all the caregiving staff members and people in the facility, all attendants and visitors should be encouraged to wash their hands before drinking, eating, providing care and between caring for patients. Creation of   Infection-Control Policy is required to detail what patients have the highest risks for contracting or passing along HAI. The policy should include information on when patients should be placed on isolation precautions or otherwise preventing contact with other patients, staff, visitors and attendants. Highly contagious infections should be identified as early as possible.

    For example, any patient admitted with a history of tuberculosis should be immediately tested to prevent its transmission to others. Such patients should be kept in isolation and provided with special care for a better result and for the benefit of other patients. Hospital staff members need to know how to identify common infections and help prevent their spread but the patients, attendants and the visitors should be equally trained and educated about HAI.  Lack of awareness is a cause behind causing such infections. Posters, signages and leaflets should be provided to spread the awareness.  Healthcare professionals and caregiving staffs should always wear gloves when interacting with patients. It is equally important to be followed by the attendants and visitors while dealing with the patients.

    The same way hand sanitizer should be also used by caregivers, attendants and visitors before and after dealing with the patients. If patients have a contagious illness, appropriate isolation equipment should be readily available for use. Attendants and visitors should be well trained to use such equipment. Such appropriate protective equipment includes waterproof gowns, gloves, shoe covers, face shields and masks. Between patients, every room in a facility should be cleaned thoroughly. This helps to prevent accidental transmission of infections as new patients are admitted. Furthermore, non-patient areas, such as the break room and nurses’ station should be cleaned daily.

    All patients should be encouraged to wear slippers or non-slip socks when walking in the hospital, including in their patient rooms. They should be provided with special dresses and should be prohibited from going to crowded areas like waiting hall, canteen, cafeteria etc during their stay in the hospital. Linens should be properly sanitized and cleaned in the laundry, but they should not be left on the patient’s beds for extended periods. Linens should be changed daily and whenever visibly dirty.

    Furthermore, linens that fall on the floor should immediately be sent back to the laundry for cleaning. No one other either a patient’s family member or relative should be allowed to use a patient’s linens. Patients should be encouraged to eat freshly cooked meals. Refrigerated foods enhance the possibility of acquiring an infection.

    To control these infections is really a challenge. These infections can be prevented and the incidence of its occurrences can be reduced only if a common man is made aware about it. The greatest role to fight against these infections is to be played by the patients’ well-wishers by following the rule, protocols and the guidelines implemented in a hospital. The healthcare givers always seek cooperation from the patients’ relatives and friends to provide a quality and patient-centric service. But lack of awareness among common people in the society has made them take this matter lightly.

    The author is a Chief Operating Officer, North East Cancer Hospital and Research Institute, Jorabat, Guwahati. The author can be reached at gitartharoymedhi83@rediffmail.com and 97065- 69388. The views expressed by the author are personal and may not in any way represent those of TIME8.

    Photo credit: cbsnews.ocm

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