Running head: LITERATURE REVIEW 1

Literature Review

Maria S. Jiménez

Alvernia University

LITERATURE REVIEW 2

Abstract

A brief review of the literature hospital-acquired infections. The objective of the literature review

was to explore effective methods to reduce hospital-acquired infections.

Keywords: hand hygiene, infection control, infection prevention, infrastructure

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Literature Review

Every year, many lives are lost because of the spread of nosocomial infections in hospitals.

Health workers can take steps to prevent the spread of infectious diseases. According to The

Centers for Disease Control and Prevention, 2 million patients suffer from hospital-acquired

infections every year, and nearly 100,000 of them die (Kemmerly, 2009). They say that most of

these medical errors are preventable. Studies show that the cost of the treatment of HAIs is

estimated at over $30 billion dollars a year just in the US alone (MacDonald, 2013).

In 1848, Ignaz Semmelweis established a link between the hands of health care workers and

the spread of hospital-acquired diseases. Semmelweis “came up with the idea of hand washing

and the use of an antiseptic solution for hands and surgical instruments” (Mangiadi, Marcovici,

2011). They ultimately rejected the idea because they believed the spread of infection was

caused by inadequate ventilation and stagnant air. On the other hand, Florence Nightingale

demonstrated that cleaning up the military hospital with fresh linens, rat poisons, and scrub-

brushed floors would result in a reduction of the death rates. There would be a reduction in

mortality from 40% to 2% in a matter of six months. Studies show that until the production of

penicillin in 1941, the percent levels of surgically acquired infections in hospitals were between

2-15%. But by late 1940s they found some penicillin-resistant strains. But by the late 1960s they

found that hospital infections were increasing. They believed it was because medical staff

became relaxed with the antiseptic techniques and the used too many antibiotics (Mangiadi,

Marcovici, 2011).

A hospital-acquired infection is a problem affecting patients, medical staff, and all the health

care system as well. According to the Centers for Disease Control and Prevention, one out of

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every 20 hospitalized patients will contract a healthcare-associated infection (Vaidya, 2013).

There are a series of strategies for infection prevention and control. Health care workers can take

steps to prevent the spread of infectious diseases. According to MacDonald 2013, hand washing

is the most simple and cost-effective approach to preventing the spread of infections. Hand

washing needs to be incorporated into the culture of the hospital system. As a result, medical

staff should wash their hands when they go in and out of a patient’s room and disinfect any

equipment and area where patients and care providers have touched with their skin (Vaidya,

2013). Studies show that in addition to hand and environmental hygiene, consistent screening of

patients should be included as part of the preoperative health evaluation. These patients should

then be treated prior to surgery or any other procedure. Sometimes healthcare providers will

contract infections while they are treating patients. Therefore, they too should keep vaccinations

up to date in order not to spread the disease to their coworkers. As another suggestion, an

infection surveillance program should be implemented to measure outcomes, assess the process

of care, and promote patient safety. Antibiotic stewardship, care coordination, and keeping track

of the latest finding, are also suggested. In addition, showing appreciation for the departments

following the protocols in the prevention program, and unit-based champions programs will help

the organizations with the prevention of infections and patients safety (Kemmerly, 2009).

Programs that prevent nosocomial transmissions from healthcare workers to patients provide

important cost savings for the institution and the health care insurer. The cost calculation for the

program should include the expense of purchasing a new product, personnel time for education,

and costs for implementation or using the device (Barnette, et al, 1999). According to the panel,

there are eight categories for a healthy and effective hospital-based infection control and

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epidemiology program. First, they suggest the management of critical data and information.

Second, setting and recommending policies and procedures. Compliance with regulations,

guidelines and accreditation requirements are also suggested. Furthermore, employee health;

direct intervention to prevent transmission of infectious diseases; education and training of

healthcare workers; personnel resources; and nonpersonnel resources are also considered.

According to the Budget Request Summary-Fiscal Year 2015, the president’s request for

CDC is $6.6 billion, a decrease of $246 million from FY 2014 enacted. The requested amount

includes $5.4 billion in budget authority, $810 million from the prevention and Public Health

Fund (PPHF), and $397 million from Public Health Services (PHS) evaluation funds.

The Morbidity and Mortality Weekly Report (MMWR, 1990-1999) states that the

Nosocomial Infections Surveillance (NNIS) is a voluntary, hospital-based reporting system to

monitor hospital-acquired infections to guide the prevention efforts of Infection Control

Practitioners (ICPs).

Nosocomial infections claim the lives of 100,000 patients each year in the US. The US

spends billions of dollars for the treatment of hospital-acquired infections. But disease control

programs are effective only if they are comprehensive and include surveillance and prevention

activities as well as staff training. Also, hospitals must provide sufficient funds to support these

programs. The implementation of programs for the prevention, transmission, and resistance of

infections would work only if the health care workers develop a hand-hygiene culture in the

organization. Hence, hands-washing is a simple and effective way to prevent illness, hand

hygiene is the most important intervention to reduce the risk of nosocomial infections.

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References

Barnette M., et al. (1999, October 20). Requirements for infrastructure and essential activities of

infection control and epidemiology in out-of-hospital settings: a consensus panel report.

Association for Professionals in Infection Control and Epidemiology and Society for

Healthcare Epidemiology of America. Retrieved from

http://www.ncbi.nlm.nih.gov/pubmed/10530650

(2014). Budget request summary-Fiscal Year 2015. Centers for Disease Control and Prevention.

Department of Health & Human Services. Retrieved from www.cdc.gov/budget

Kemmerly, S. A., & Reed, D. (2009, Spring). Infection control and prevention: A review of

hospital-acquired infections and the economic implications. Department of Infection

Control. Retrieved from http://www.nbci.nlm.nih.gov/pmc/aricles/PMC3096239/

MacDonald, I. (2013). Hospitals get tough with hand-washing offenders. Fierce Healthcare.

Retrieve from http://www.fiercehealthcare.com/story/hospitals-get-tough-hand-

washing-offenders/2013-05-29

Mangiadi, J. R., & Marcovici, R. (2011). History of hospital acquired infections. Optimus.

Retrieved from http://optimusise.com/history-hospitas-infection.php

(2000, March 03). Monitoring hospital-acquired infections to promote patient safety – United

States, 1990-1999. Centers for Disease Control. Morbidity and Mortality Weekly

Report. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4908al.htm

Vaidya, A. (2013). 10 Best strategies for infection prevention and control. Beckers Hospital

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Review. Retrieved from http://www.beckershospitalreview.com/quality/10-best-

s trategies-for-infection-prevention-and-control.html

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