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The CDC's Winnable Battles in Public Health: Hospital Acquired Infections

By HERWriter
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When I think of the important battles in public health -- issues that our society recognize as priorities due to widespread problems or needs -- the issue of Healthcare Associated Infection (HAI) doesn’t necessarily cross my mind right away.

But this is because I was totally unaware that according to the CDC’s data, one out of 20 patients who are hospitalized each year contract an HAI while undergoing treatment.

HAIs claim the lives of many people who already have vulnerable health statuses and incur huge costs for the health systems. According to the Agency for Healthcare Research and Quality (AHRQ), “HAIs are the most common complication of hospital care and one of the leading causes of death in the US.”

On top of this, the cost associated with these infections is estimated at an excess of $28 to $33 billion. Clearly, this is a bigger battle than I originally thought!

Healthcare Associated Infections are caused by a “variety of common and unusual bacteria, fungi, and viruses” and are often related to devices such as catheters, ventilators or central lines, which are inserted into the body to perform important procedures.

These infections can occur either at the surgical site, or as part of a more systemic infection. HAIs may also be caused by prolonged use of antibiotics while hospitalized, which can result in a gastrointestinal infection called Clostridium difficile infection.

Additionally, methicillin-resistant Staphylococcus aureus (MRSA) is a staph bacteria that is resistant to certain antibiotics, and occurs most frequently among patients in health care settings whose immune systems are already compromised and who come in contact with others who are already infected.

MRSA is most often a skin infection, and is also commonly spread in other situations where people come into close skin-to-skin contact like athletic facilities or dormitories.

Luckily, health professionals have made huge strides in reducing rates of HAI in hospital settings through increased education of providers, better enforcement of sterilization procedures and more research/surveillance at local, state and federal levels.

As a result, since 2001, medical professionals have reduced HAIs in intensive care unit patients by 58 percent, saving close to 27,000 lives and $1.8 billion dollars. Furthermore, infections associated with central lines (one of the deadliest and most common HAIs) were reduced by 73 percent.

Another effort to prevent HAIs focuses on the education of medical professionals and a regulation of the settings or procedures that provide outpatient care. Previously, infection prevention strategies were far less comprehensive for patients receiving care in their homes, hemodialysis centers or in ambulances. By providing guidelines and recommendations on sterilization and disinfection of equipment, the CDC has helped to reduce infection rates overall.

So, what can you do to protect yourself from acquiring an infection in a health care setting? You may feel helpless to prevent some of the more serious conditions, but there is plenty we can each do to prevent transmission.

1. Wash your hands often and thoroughly. It sounds silly, but it saves lives.

2. Speak up! Talk to your doctor about any concerns you have and ask what they will do to protect you. Clarify, "will there be a new needle, new syringe, and a new vial for this procedure or injection?" The answer should always be yes.

3. Follow directions for taking medication. Take it exactly as prescribed and do not take it if it is not recommended by a doctor. Remember that antibiotics will not cure a virus like the flu or the common cold. This will help to prevent drug resistance.

4. Follow the directions for pre-surgery preparation. Clean the site as your provider recommends.

5. Know the signs of an infection and learn more about the symptoms of MRSA, C. difficile or surgical site infections. Speak to your doctor if you suspect any problems.

6. Read more about HAI at http://www.cdc.gov/HAI/index.html!


“Healthcare-Associated Infections.” September 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/hais.htm

“Healthcare Associated Infection.” September 2011. Centers for Disease Control and Prevention. Atlanta, GA. http://www.cdc.gov/HAI/index.html

Reviewed October 24, 2011
by Michele Blacksberg RN
Edited by Malu Banuelos

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EmpowHER Guest

Great job bringing the HAI issue to people's attention, Hannah. Unfortunately too many people are educated the hard way - only learning about the potential problem after it is affecting them or their loved ones. Pat Mastors, who lost her father to a HAI, now acts as a patient safety advocate to empower and help prevent tragedies due to HAI. She recent wrote:

"We can’t have enough awareness of how important it is to be proactive as hospital patients. The environment in these facilities is just too complex, the “bugs” that make us sick are getting stronger every day, caregivers are busier than ever, and even the best of them can’t attain perfection in ensuring no harm will come to us. The risk of infection is around 1 in 15, and studies show one in 3 patients will suffer some kind of medical error while hospitalized. There is no “re-do” of a hospitalization; what I’m passionate about is engaging patients to help ensure we “get it right” the first time. We’ve got to use our eyes, ears and brains, and contribute!

Vigilance is key — before and during your stay. If you must have surgery, ask about the infection rate for that procedure (and how many of them that surgeon has done. You should also understand which part of the surgery may be performed by a less-experienced associate). Do advance online research about your hospital at http://hospitalcompare.hhs.gov and bring an advocate to the hospital with you (24/7, if they’ll do it). Bring a notepad, pen and hand sanitizer (and use it often), and write everything down (medications, doses, names of people caring for you, etc.) If you’ll be in the hospital for a while, ask about the chain of command early on, before there are problems, so you’ll have the info in case something comes up. Make sure the doctor leaves an order for pain and sleeping meds if needed before s/he leaves for the night. A download of six essential tips is available on our website, and there are links to other organizations that inform and educate here: http://www.thepatientpod.com/helpful-links.html. Last, if it’s ever in your life important to be nice to the staff, it’s while you’re in the hospital. They’re busy and stressed, too. If you can help a hospitalized loved one by straightening the bed or fetching water, it frees the staff for higher-level tasks. You’ll find them appreciative, and when you really do need them, they’ll likely be more responsive.

All of this advice was hard-won by fellow patient advocates who’ve lived through tremendous personal loss when things fell through the cracks. None of us wants this to happen to others.
There are literally hundreds of organizations in this country — within the medical profession, government and the patient advocate community — working to improve patient safety, patient engagement and patient awareness. Yet, as harm in hospitals continues, obviously we’re not doing a good enough job of fixing things. So, apologies for being so long-winded … but if even one person reads this and it makes a difference, it’s worth it."

Mastors lobbied successfully to pass two Rhode Island state laws improving patient safety, and in 2010 was one of a select group of patient advocates invited by the Institute for Healthcare Improvement to participate in its first-ever Leadership Summit for Patient Activists and Partners in Quality and Safety. Mastors serves on the HAI reporting advisory committee for the Rhode Island Department of Health, and on the Advisory Board to the Small Business Development Center at Johnson & Wales University. She also founded Pear Health, LLC and created a portable patient safety and wellness product called The Patient Pod. Come join our wellness conversation on Facebook.

Thanks Hannah!
Pear Health, LLC

October 24, 2011 - 11:31am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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