Healthcare-Acquired Infections (HAIs)
A healthcare-acquired infection (HAI) is an infection that is contracted while you are in a healthcare facility, such as an acute care hospital or a skilled nursing care facility. Even a doctor’s office or clinic can be a source for an HAI. The medical community calls HAIs nosocomial infections. Infections that develop outside a healthcare facility are called community-acquired infections.
As with any type of infection, HAIs can trigger sepsis, particularly in people who are already at risk, such as those with chronic illnesses (like diabetes), who are immunocompromised (such as those taking chemotherapy or who don’t have a spleen), the very young, and the very old.
Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection. Sepsis kills and disables millions and requires early suspicion and treatment for survival.
Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.
How do healthcare acquired infections happen?
Anyone can get an infection, but as with certain people in the community, many people in hospital environments have a higher risk of getting an infection because of chronic illness, age, or other risk factors. And then there are added risks in hospitals and other healthcare facilities:
Concentrated exposure to germs: If you are in healthcare facility, you’re in an environment with other sick people who may have infections that could be spread. You’re also usually exposed to more people while you’re in a healthcare facility than you might normally be (workers, volunteers, and visitors, for example), and these people could unknowingly transfer germs from patient to patient.
Invasive interventions and devices: If you have had any type of intervention that causes a break in your skin
or introduces a piece of medical equipment inside your body, there’s a new path that bacteria can follow to cause an infection. The most common interventions that can cause an infection include:
– Central lines (also called central venous catheters) – People who are seriously ill may be given a central line, a special type of intravenous (IV) catheter, so the nurses can effectively provide antibiotics or other medications and fluids. Usually, central lines are used in specialized units, such as the intensive care unit (ICU).
The central line is inserted into a large vein in your groin, chest or neck. Because these special IVs are in a large vein, they can stay in place for several weeks or longer, eliminating the need to keep restarting IVs in the more delicate veins in the arm. However, a drawback is that these larger veins give more direct access to the heart, and infections can become very serious very fast.
An infection from a central line is called a central line-associated bloodstream infections, or CLABSI.
– Urinary tract infections – Patients in the hospital and in long-term care facilities may have a urinary catheter – a tube inserted into the urethra, which drains urine from the bladder. An infection caused by a urinary catheter is called a catheter-associated UTI, or CAUTI. According to statistics, 75% of all UTIs in the hospital are CAUTIs, and they are the most common type of healthcare-acquired infection today.
– Surgical site infection – If you have surgery, your wound is at risk for getting infected. The severity of the infection can range from a superficial infection in the skin around the surgical incision, to a much deeper internal infection. Surgical site infections are called SSIs.
– Ventilator-associated pneumonia – When people are on a ventilator because they need help breathing, they are at risk for developing pneumonia, an infection in the lungs. Called ventilator-associated pneumonia, or VAP. There are many possible causes for this type of infection, including exposure of the lungs (from the tube) to bacteria that may not normally be able to reach the lungs.
– Pressure injuries – Patients how are confined to bed or spend extended time in a chair or wheelchair are at risk for developing a pressure injury or sore. Seniors can also have fragile skin that tears easily. These injuries can become infected, as well.
What types of infections are HAIs?
Technically, any type of infection caught in a healthcare facility is an HAI, however some types of bacteria are more common in these types of places than others. These include, among others:
- Methicillin-resistant Staphylococcus aureus, commonly referred to as MRSA.
- Clostridium difficile, often called C. difficile or C. diff.
- Vancomycin-resistant Enterococcus.
Treating HAIs is the same as treating any other type of infection, with the appropriate antibiotics. But treatment can be more difficult because of pre-existing conditions and because some of the bacteria causing these infections are becoming antibiotic resistant.
The focus on healthcare acquired infections is now on prevention and in most cases, prevention is very basic: proper hand washing and good environmental hygiene.
- All people who enter a patient’s room or touch a patient must wash their hands before and after, even if they wear gloves.
- Patient rooms, as well as common rooms and facilities must be properly cleaned on a regular basis.
- Medical equipment must be properly washed and sterilized (when appropriate).
- Invasive procedures should be limited as much as possible and for as short a period of time as possible.
- Healthcare providers must correctly observe sterile processes when performing procedures, such as changing wound dressings and inserting urinary catheters.
- Patients should have well-ventilated private rooms as often as possible.
- Patients should be monitored closely for any signs of infection.
How you can reduce your risk of developing an HAI
- Ensure that everyone who comes into your room, either to provide care or just to visit, washes their hands.
- Wash your own hands frequently and thoroughly.
- Report any signs or symptoms of an infection, such as increasing redness around a wound, unexpected drainage from a wound, cloudy or foul-smelling urine, fever, chills.
- Whenever you to take an antibiotic, take it only as prescribed and for the full duration of the prescription, even if you feel like your infection has gone away.
- Don’t use someone else’s antibiotic to treat what you think might be an infection.
If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.”
The information on healthcare acquired infections is also available as a Sepsis Information Guide, which is a downloadable format for easier printing.
Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.
Updated August 30, 2020.