Dr Pankaj Raina
Hospital-acquired or healthcare-associated infections (HAIs) are infections that patients acquire during their hospital stay, particularly manifesting 48 to 72 hours after admission, and are more commonly observed in critical care units. As per World Health Organization (WHO), high-income countries report approximately 5-12% of patients with HAIs.
What effect can HAIs have on patients?
Intravenous route-related infections are a growing problem across the world. The use of intravenous route in hospitalized patients carries adverse reactions and complications. Most patients require at least one venous access device for administering intravenous fluids and medications during their hospital stay. The most common ones include central venous access devices (CVADs) or peripheral intravenous catheters (PIVCs). Indian statistics report approximately 30% of hospitalized patients with phlebitis, a common IV route-associated infection with PIVCs.
The use of central venous access devices (CVADs) can lead to central line-associated bloodstream infection (CLABSI). Common causes of CLABSI include contamination on insertion, contaminated IV components or infusion, blood-borne infection from another body site, and non-intact dressing. The most common complication arising from the use of PIVCs include swollen vein or phlebitis, occlusion, infiltration, extravasation, and dislodgment of the catheter.
These HAIs lead to increased hospital expenses and patient costs. Other consequences of HAIs include increased complications, pain and discomfort, prolonged hospital stay, laboratory procedures, the possibility of antibiotic resistance, etc.
Importance of following safety practices in the wake of COVID-19
COVID-19 third wave has hit and is creating havoc worldwide. Owing to this deadly third wave, healthcare facilities must ensure that staff follows stringent hygiene and infection control practices for patient safety.
Noteworthy measures to follow include are Triaging and cohorting of patients, sticking to standard infection control practices as recommended by WHO and CDC and use of N95 masks and other PPEs
Besides following the above measures, another critical factor includes maintaining hand hygiene. The latest Infusion Therapy Standards of Practice 2021 guidelines recommend the following hand hygiene measures for clinicians and staff.
The hospital staff should perform hand hygiene to protect the transfer of microorganisms before and after having direct contact with the patient, after getting exposed to body fluids or secretions, mucous membranes, and wound dressings, after touching the patient’s surroundings, before wearing gloves, after removing gloves, before, during, and after all clinical procedures requiring Aseptic Non-Touch Technique (ANTT), such as insertion and removal of all vascular access devices (VADs).
The latest Infusion Therapy Standards of Practice 2021 guidelines also recommend ongoing management and manipulation of indwelling medical devices, infusion administration, routine use of an alcohol-based hand rub (ABHR), consisting of at least 60% ethanol or 70% isopropyl alcohol, with the use of ABHR for at least 20 seconds and immediately in between each step of removing and after removing PPE, and before leaving the patient’s environment.
Hand hygiene is of utmost importance in Critical Care. It is possible to bring down HAIs through strict compliance with standard infection control practices.
Use of latest VADs for patient safety
Apart from following hand hygiene and other infection control measures, healthcare facilities should also ensure the use of highly advanced and latest vascular devices to provide quality care to their patients.
An international study conducted by Becton, Dickinson, and Company (BD), indicates that the use of PosiFlushTM pre-filled saline syringes resulted in a considerable reduction in CRBSIs (from 12.2 to 3.4%).
Other important benefits of pre-filled saline syringes include the following like elimination of syringe-induced blood reflux, increased patency of the catheter, prevention of syringe contamination during initial aspiration, reduced possibility of medication errors and decreased hospital and patient costs
With the arrival of COVID-19 3rd wave, hospitals and all the healthcare staff need to be extra careful. They should strictly adhere to standard infection control practices, hand hygiene compliance, and systematic use of PPEs. The standard infection control practices should be made part and parcel of the clinical practice.
(The author is Medical Affairs Leader MDS- India/South Asia, Becton Dickinson (BD). The article is for informational purposes only. Please consult health experts and medical professionals before starting any therapy or medication. Views expressed are personal and do not reflect the official position or policy of the Financial Express Online.)