This article was medically reviewed by Dr. Rohit Bhalla
Infection prevention within the hospital setting has become an important topic during the COVID-19 pandemic. As more sick patients enter facilities, it is paramount to ensure the safety of staff and noninfected patients against the spread of coronavirus. However, diseases contracted during a hospital stay, or hospital-acquired infections (HAI), have long been an issue in the world of healthcare. In fact, 1 in 25 patients contract a hospital-acquired infection during a hospital stay. This number has a huge impact on healthcare organizations and the patients they care for in terms of the length of stay, added costs, and most importantly, patients’ lives.
In this article, ID Care physician and infectious disease expert, Dr. Rohit Bhalla, explains what hospital-acquired infections are, which patients are at the highest risk for contracting them, and what hospitals can do to improve hospital-acquired infection prevention within their facilities.
The Most Common Hospital-Acquired Infections and Who is at Risk
Hospital-acquired infections are caused by viral, bacterial, and fungal pathogens, often entering the body through invasive devices or procedures. Patients at the highest risk for contracting a hospital-acquired illness are those who are over the age of sixty-five, suffer from obesity, or have underlying health issues, such as cardiac disease and high blood pressure.
The most common types of hospital-acquired infections are bloodstream infection (BSI), pneumonia (eg, ventilator-associated pneumonia [VAP]), urinary tract infection (UTI), and surgical site infection (SSI). “Hospital-acquired infections are usually a result of what healthcare professionals do to patients as far as putting in urinary catheters, central line catheters, and similar devices,” said Dr. Bhalla. “When putting a foreign object inside someone’s body, the longer that device stays in, the more likely it is to cause an infection.”
Another common type of hospital-acquired infection is C. diff (also known as Clostridioides difficle or C. difficle), caused by the overuse of antibiotics, creating a bacterium that becomes resistant to multiple antibiotics over time. This bacterium leaves patients with severe diarrhea and inflammation of the colon. Unlike the hospital-acquired infections mentioned above, C. diff, like COVID-19, is a contact organism that can be transferred from room-to-room.
While contact organisms like C. diff and COVID-19 are different from central line-, catheter-, and ventilator- associated infections – they are all very dangerous in their own right. Fortunately, an infectious disease expert, like those at ID Care, can help significantly reduce the rate of hospital-acquired infections within a facility in several ways.
Through ID Care, healthcare organizations can strengthen their access to more diligent patient care, improved infection prevention and isolation protocols, and the antimicrobial stewardship programs (ASP) needed to reduce the overuse of antibiotics.
Hospital-Acquired Infection Prevention Through Improved Patient Care
Understanding how and why unusual or complicated infections occur requires an infectious disease specialist. ID Care physicians focus solely on the prevention, diagnosis, and treatment of infectious diseases; therefore they spend more time monitoring at-risk patients. “If a patient has a urinary catheter in place and they don’t really need it, we usually recommend to take it out,” said Dr. Bhalla. “If a patient has a central line catheter in place, and they can eat and drink safely, we’ll recommend to take that out as well. These devices pose a huge risk, and if they’re not monitored correctly, they may be doing more harm than good. Other doctors may not think this way. But we do.”
While every patient and infectious disease is different, the best infectious disease care— with the lowest potential for adverse effects — comes from an expert who understands the risks and gives patients the extra attention needed to avoid them.
ID Care is the largest independent infectious disease practice on the East Coast, and the second largest in the United States. In addition, ID Care has New Jersey’s largest network of board-certified infectious disease physicians and is a longstanding partner of some of the most renowned healthcare organizations in the state. However, what really sets ID Care apart is an attention to detail. By focusing on the little things, hospital-acquired illnesses can be more easily avoided along every step of the patient journey.
Upholding Infection Prevention and Isolation Protocols
During the COVID-19 pandemic, strengthening infection prevention and isolation protocols is so important. ID Care has helped healthcare organizations across New Jersey create and implement the most effective measures for handling the surge in patients. In fact, to date, ID Care has helped treat more than 25% of hospitalized COVID-19 patients in the state. However, as mentioned earlier, there are other infections that spread through contact as well, such as C. diff.
It is important to ensure that contact organisms like C. diff and COVID-19 don’t spread to other parts of a facility, endangering patients and staff. However, there isn’t a one-size-fits all approach to ensuring a facility is following the right procedures. Infection prevention and isolation protocol is different from disease to disease. ID Care is expertly equipped to help healthcare organizations with the recommendation, implementation, and supervision of a wide range of infectious disease protocols to ensure safer results when it comes to every hospital-acquired infection.
“First, we want to know how each organism is transmitted,” said Dr. Bhalla. “And based upon the transmission, we’ll help decide what healthcare workers need to do to ensure the safety of themselves and their patients. In the case of COVID-19, it was a question of transmission between either droplet or aerosol. So, we had to decide whether healthcare workers needed to wear surgical masks or N95 masks when dealing with infected patients. But the question wasn’t as simple as one or the other. While COVID-19 has been proven to spread through droplets, a device a patient might wear, such as a high-flow oxygen mask, may temporarily aerosolize the virus. Therefore, a N95 mask or a surgical mask may be required depending on the case. At ID Care, we help solve protocol questions like these all the time. And we’ve been doing it long before COVID-19.”
Knowing how infections present themselves in the body – and the best way to treat them— is important. However, when it comes to hospital-acquired infections, understanding how organisms are transmitted and preventing the spread is the best way to ensure healthcare workers and patients remain safe. The infectious disease experts at ID Care are always up-to-date on the latest infection prevention and isolation protocols needed to help hospitals create tailored solutions to combat any and every hospital-acquired infection.
Antibiotic Stewardship: Creating a Foundation for Hospital-Acquired Infection Prevention
In terms of hospital-acquired infections, C. diff is a major problem in hospitals all over the world. In the United Sates it is estimated to cause almost half a million infections a year. How can it be stopped? By understanding what causes it.
Poor antibiotic prescribing practices put patients at risk for C. diff infections. In fact, more than half of all hospitalized patients might get an antibiotic at some point during their hospital stay, but studies have shown that up to 50% of antibiotics prescribed in hospitals are unnecessary or incorrect.
“The more you use antibiotics, the more bacteria starts to colonize and become resistant to those antibiotics,” said Dr. Bhalla. When bacteria like C. diff starts to develop a defense system against antibiotics, healthcare facilities and patients lose. The right antibiotic stewardship program, led by infectious disease experts specializing in antibiotics, can help hospitals not only reduce the rate of hospital-acquired infections, but also improve overall patient care.
“Our antibiotic stewardship program entails a thorough review of the antibiotics ordered for every patient,” said Dr. Bhalla. “It’s up to us to decide if what has been ordered is an appropriate use of antibiotics. For instance, if someone has symptoms of an upper respiratory infection, generally that’s viral, and broad spectrum antibiotics would not be needed. So we would encourage symptomatic treatment as opposed to antibiotic treatment. What we try to do is evaluate every patient on a case to case basis to see if there’s a better option in terms of antibiotics, or perhaps if there’s an option that doesn’t require antibiotics at all. A lot of physicians don’t know every avenue available for their patients. At ID Care, we take an active interest in figuring these things out and helping to prevent the overuse of antibiotics.”
The main focus of antibiotic stewardship is to provide the highest quality infectious disease services by implementing strategies proven to minimize or negate hospital-acquired infections. By identifying problems, collecting and analyzing data, as well as providing intervention through changes in policies and procedures, a comprehensive antibiotic stewardship program can improve the safety and capabilities of clinical organizations and facilities drastically. In fact, ID Care has already helped many hospitals across the state of New Jersey claim a position among the highest performers in antibiotic stewardship. By providing patients with the least amount of medication, it is possible to achieve the safest and most effective results while avoiding the spread of hospital-acquired infections like C. diff.
Strengthen Your Hospital-Acquired Infection Prevention with the Infectious Disease Experts
Yes, infection prevention has become an important topic during the COVID-19 pandemic, but it is up to hospitals to continue fighting for the cause even after the pandemic. At ID Care, we are proud to stand beside our hospital partners in the fight against hospital-acquired infections – today, tomorrow, and beyond. As infectious disease consultants, we can help your hospital provide more diligent patient care, improve infection prevention and isolation protocols, and create an antimicrobial stewardship program you can be proud of. If you want to learn more about how ID Care can help, call 908-281-0610 to schedule a consultation with an ID Care expert or visit the ID Care partner page to learn more.