Hospital-Acquired Infections (HAI) Paper

Hospital-Acquired Infections (HAI) Paper

The two articles by Chirca (2019) and Dancer (2010) reveal the fight against Hospital-Acquired Infections (HAI) is becoming a concern more than before. The hospital is supposed to be a place of comfort; however, emerging evidence shows that the hospital is becoming unsafe for patients due to the presence of drug-resistant pathogens in hospital facilities. Such environments expose patients to higher risks of HAI when admitted to a hospital. The articles further indicate gaps in epidemiology studies in proposing the best strategies for preventing HAI.

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Even though hospitals have developed effective disinfection measures, contamination levels continue to increase and cause more disease transmissions in hospitals. For example, a body of evidence supports ultraviolet light disinfection technology to detect pathogens as an effective measure for fighting HAIs. However, this method kills specific classes of pathogens and is not effective on others. Every solution presented by the article has its demerits, which is why the HAI problem remains unsolved. From the information gathered, I would like to invest my effort in developing sanitization programs for hospitals and propose developing more effective disinfectants to reduce HAIs Hospital-Acquired Infections (HAI) Paper.

Concerns Addressed in the Articles

There is an increasing threat of multi-drug resistant infections occurring in hospitals. As healthcare systems continue to focus on developing effective disinfectants, new types of pathogens have emerged, called nosocomial pathogens resistant to many drugs. For example, Dancer (2010) reveals Acinetobacter spp has shown resistance against methicillin in environments with known methicillin colonization status. The pathogen has shown resistance against vancomycin increases secondary transmission rates in rooms previously occupied by infected patients. C. Difficult or Acinetobacter is an example of a multi-drug resistant pathogen that can live on hospital surfaces close to patients. Circa (2019) gives examples of multi-drug resistant pathogens that include Vancomycin-Resistant Enterococci (VRE). The author reveals the pathogen started developing drug-resistant in 1986, thirty years after a vaccine was made. Since the vaccine’s discovery, the pathogen has progressively been showing resistance and causing more transmission rates in the United States. An estimated 1000 deaths have been reported in the United States due to Vancomycin-Resistant Enterococci (VRE) infection. Facile et al. (2019) indicate the pathogen is multi-drug resistant because it has a prolonged survival period in the hospital environment. It can resist regular cleaning practices using powerful disinfectants, such as bleach-based cleaning soaps. This pathogen can survive on a surface after improper cleaning, especially on surfaces that are not profoundly rubbed. This can be why there is an increased VRE acquisition for patients placed inside a contaminated room. This happens to patients admitted into a VRE-colonized room. However, Dancer (2010) reveals a patient that has previously been in a VRE-colonized room has no increased risk of transmission due to the differences in VRE-molecular strain typing Hospital-Acquired Infections (HAI) Paper.

Another concern is the lack of hygiene within the hospital environment has led to an increased rate of HAI. There is a complex interplay that involves contaminated healthcare workers’ hands, contaminated equipment, and contaminated rooms. Healthcare workers can transmit HAI through improper hand hygiene, such as transferring pathogens from contaminated surfaces to clean areas using their handheld devices. For instance, Chirca (2019) reveals methicillin-resistant Staphylococcus aureus (MRSA) is known to have a high colonization status because of its prolonged survival period. The pathogen can survive for months, depending on hospital hygiene conditions, location, biofilm formation, and cleaning products. Areas easily contaminated with the pathogen include surfaces close to patients, such as bed bars, taps, tables, and bed pillows. Circa (2019) adds that multi-drug resistant pathogens have high latency on surfaces, which means they can survive against cleaning and disinfection and increase the risk for HAI. Moreover, health care workers contribute to HAIs through “non-classical” surfaces, such as mobile phones, personal computers, and protective garments using in operating rooms.

Another challenge is assessing the effectiveness of microbiological sampling in addition to environmental cleaning and disinfection. As Chirca (2019) reveals, healthcare organizations do not recommend routine sampling of hospital pathogens to be conducted, which is why getting rid of them remains a problem. Pathogens, such as Candida Auris, are resistant to antiseptics and disinfectants and can survive for seven days after a thorough cleaning exercise. The effectiveness of disinfectants on this pathogen is still unknown since interventions proposed to eliminate the pathogen are usually quasi-experimental in design. Moreover, over the last thirty years, A. Bowman has become a multi-drug resistant pathogen and a nosocomial threat because of its associated pathological characteristics. This is due to the non-selective use of disinfectants as a part of the general hospital routine. Several investigations have reported the pathogen can survive on dry surfaces under challenging conditions, further facilitating persistence and transmission for more than four months. The pathogen can survive in poorly ventilated environments and has acquired resistance to several antimicrobial drugs.

Possible Solutions

One possible solution to multidrug-resistant infections in hospitals are implementing an enhanced cleaning on surface contamination. This includes an association with hand hygiene to prevent the transfer of such pathogens from one hospital room to another or from a health worker to a patient. Dancer (2010) highlights the importance of hospital sanitization is confirmed in Brazil and Australia studies that have shown a reduction of VRE transmission due to the practice. The authors suggest a set of cleaning activities, including providing contact precautions and educational programs for hospital staff. The two actions have led to a significant reduction in HAI.

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An Additional Solution

There have been concerns that using technologies in making hospital equipment can reduce HAIs, such as installing hospitals with equipment made from metallic silver and copper. As Chirca (2019) reveals, silver and copper effectively prevent the colonization of pathogens on hospital surfaces. The two types of metals can reduce environmental contamination. This measure can help reduce the negative effect caused by HAIs, especially for patients admitted to care units. Surfaces coated with antimicrobial polymers have shown positive results in reducing HAIs. For example, titanium coating has shown positive results in HAI reduction (Chirca, 2019). The use of antimicrobial coating technology together with hospital sanitization can be a practical approach towards decreasing HAIs Hospital-Acquired Infections (HAI) Paper.

How the Information has Impacted My Career

The information from the two articles has given me an insight into a new area of focus as a health worker. I have become interested in promoting hospital sanitization as a core standard for the prevention of disease transmission. I have learned that while patients receive treatments for primary diseases, they face the risk of acquiring secondary infections. Pathogens have been resistant to disinfectants, vaccines, and cleaning measures. The two articles indicate some pathogens can stay alive for 30 days on dry surfaces, making it hard for hospitals to get rid of them. Pathogens hide in places that are difficult to disinfect, such as inside pillows. I can develop sanitization programs to improve hygiene in the healthcare environment and write proposals regarding the effectiveness of disinfectants used in hospitals today. I believe my research will contribute to the development of effective disinfectants in reducing HAIs.

References

Circa, I. (2019). The hospital environment and its microbial burden: Challenges and solutions.

Future Microbiology, 14 (12), 1007–1010. https://doi.org/10.2217/fmb-2019-0140

Dancer, S. J. (2010). The role of environmental cleaning in the control of hospital-acquired

Infection. The Journal of Hospital Infection, 73 (4), 378-385.  https://doi.org/10.1016/j.jhin.2009.03.030 Hospital-Acquired Infections (HAI) Paper.

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