Hospital negligence occurs in a multitude of forms, leading among them is the incidence of hospital-acquired infections (HAIs). In fact, there were approximately 722,000 hospital-acquired infections in United States acute care hospitals in 2011, according to the Centers for Disease Control and Prevention (CDC). Of those patients affected by hospital-acquired infections, 75,000 died. Hospital-acquired infections have been recognized as such an important issue in the American medical community today that the CDC dedicates a specific program, called the National Healthcare Safety Network (NHSN), to monitor and attempt to prevent the occurrence of hospital-acquired infections. In this article, we will examine hospital-acquired infections more thoroughly to understand when they occur, how they occur, and the potential results of HAIs for patients.
Hospital-Acquired Infections by the Numbers
In 2014, The New England Journal of Medicine published the results of the Health-Acquired Infections Prevalence Survey, which was conducted on a national scale in 2011. In its first sentence, the article stated, “Elimination of health care–associated infections is a priority of the Department of Health and Human Services.” With this as its guiding purpose, the survey sought to “estimate the prevalence of health care–associated infections in acute care hospitals, determine the distribution of these infections according to infection site and pathogen, and generate updated estimates of the national burden of these infections.” The findings of the survey were highly informative.
Researchers found that major sites of infection could be broken down into several categories: Pneumonia and surgical-site infection were the prevailing category, followed by gastrointestinal infection, urinary tract infection, and primary bloodstream infection. So how are these infections acquired in acute care hospitals? Some are deemed “device-associated infections,” while others are surgical-site infections, and the remainder are not associated with devices or surgical procedures. Common devices that lead to hospital-acquired infections include ventilators, urinary catheters, and central lines.
Medical Devices and Hospital-Acquired Infections
A ventilator is a machine that is used to assist a patient with breathing. Ventilators can be used temporarily during surgical procedures in which the patient is under anesthesia, to treat lung disease and conditions that compromise breathing, and long-term for those who can no long breath on their own. Unfortunately, ventilators are also a cause of hospital-acquired infections, specifically, causing pneumonia.
Catheters are hollow tubes, potentially compromised of rubber, plastic, silicone, or latex, that are used to drain fluid. Urinary catheters are inserted into the urethra and they connect to a bag that collects drained urine. Urinary catheters can be used temporarily to assist patients until they can resume urinating on their own. They may also be necessary long-term for patients who have sustained a permanent injury or suffer from a serious illness. Notably, urinary catheters can also cause hospital-acquired infections, specifically, urinary tract infections.
A central line can also be referred to as a central venous line, central venous catheter, or a central catheter. It is a needle inserted into a large vein, typically in the neck or near the heart. A central line can be used for diagnostic or monitoring purposes, to estimate cardiac output, blood pressure, arterial pressure, or vascular resistance. It can also be connected to a tube and used to administer medicine, fluids, or nutrients. While central catheters can be life-saving, they can also be fatal when they cause hospital-acquired infections, specifically, infections in the blood stream.
Other Causes of Hospital-Acquired Infections
According to the CDC, approximately 1 in 25 patients in U.S. hospitals contract a hospital-acquired infection each year. In addition to the medical device-associated infections discussed above, surgical site-infections account for an estimated 21.8% of hospital-acquired infections. Specifically, the HAI Prevalence Survey found that the most surgical-site infections occurred in colon surgeries, followed by hip arthroplasties, and small-bowel surgeries. Aside from surgical-site and device-associated infections, hospital-acquired infections can occur in intensive care units, emergency rooms, and elsewhere, due to bacteria and pathogens that linger on surfaces, tools, and other unsterilized areas. Regardless of the source of a hospital-acquired infection, these conditions can be deadly if not immediately identified and treated. In addition, hospitals whose negligence contributes to HAIs can be held accountable through medical malpractice litigation.
