Healthcare-Associated Infections Research Paper

Major Research Assignment

Healthcare-associated Infections

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Table of Contents

Abstract        3

Introduction        4

Investigation of Research Questions        7

1. Which is the major factor in causing HAIs?        7
2. How responsible are HCWs for HAIs?        11
3. Are current HAI preventive measures sufficiently effective in decreasing HAI rates?        15
4. How can preventive measures be optimized to lower HAI rates?        18

Communication with Experts        21

Conclusion        25

Synthesis        25

Evaluation and Justification        30

Final Comments        33

References        34

Appendices        38

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Abstract

Healthcare-associated infections (HAIs) are secondary infections acquired by patients during a course of treatment in healthcare facilities, which arise from pathogenic microorganisms invading the body and pose unnecessary burdens for patients and healthcare systems as a whole. As healthcare workers (HCWs) are main agents in delivering health services, this research focuses on the point at issue, ‘Preventable HAIs are mainly caused by HCWs so prevention measures should be targeted towards HCWs’. The objective of this report is to assess HAI-causing factors: healthcare environments, health organisational systems and HCWs; in order to optimize HAI interventions. Within these factors, HCWs have been identified to be the main cause of preventable HAIs. This research concludes that HAI preventive measures should target HCWs through positive reinforcement.

Introduction

Healthcare-associated infections (HAIs) are diseases contracted by patients, which are not initially present or latent upon admission into healthcare facilities (Nejad et al.

2011). HAIs include infections contracted by a patient’s visitors or by healthcare workers themselves (Nejad et al. 2011). As a leading cause of morbidity and mortality in healthcare sectors, HAIs result in preventable deaths and unnecessary costs for health systems worldwide (Murni et al. 2015, p. 454). The burden of HAIs is especially heavy for less- developed and developing countries, due to financial constraints that these nations face [World Health Organization (WHO) 2011]. More importantly, Ocran and Tagoe (2014) establish that approximately one third of HAIs are considered preventable, and the WHO (2011) describes that the burden of HAIs can be decreased by 50% or more.

HAIs arise from multi-resistant organisms (MROs) and are easily contracted by patients, due to high microorganism exposure and compromised patient immune systems (Gilbert et al. 2009). Besides intrinsic factors which make patients prone to HAIs, Zuberi et al. (2015) mention other factors which contribute to the prevalence of HAIs, such as the environment of a healthcare facility; indiscriminate use of antibiotics by physicians; and general work practices of all healthcare workers (HCWs). While sufficient aseptic guidelines are in place, levels of compliance by HCWs to such guidelines still need to improve (Gilbert et al. 2009).

Decreasing HAI rates is important for patient safety and satisfaction with health services, and allows for greater transparency and accountability in medical practice (Pyrek

2016). Measures to curb HAIs include hygiene protocols, improving antibiotic usage, educating healthcare workers and implementing national surveillance to monitor HAIs (Munrni et al. 2014). According to Graves et al. (2009), efforts made to reduce HAI rates can potentially improve efficiency and cost-effectiveness of healthcare systems.

From previous research (Zuberi et al. 2015; Gilber et al. 2009), an exact primary cause of HAIs has yet to be specified. This acts as an unresolved issue, prompting a need to develop and refine existing HAI preventive measures. This research report seeks to address and evaluate determinants of HAIs, and to assess effectiveness of HAI preventive methods in maintaining low incidences of HAIs. The point at issue, ‘Preventable HAIs are mainly caused by HCWs so prevention measures should be targeted towards HCWs’, will be investigated in this report.

The following research questions will guide further discussion:

1. Which is the major factor in causing HAIs?

1. How responsible are HCWs for HAIs?

1. Are current HAI preventive measures sufficiently effective in decreasing HAI rates?
2. How can preventive measures be optimized to lower HAI rates?

The first question identifies factors which contribute to the development and emergence of HAIs, in order to establish a leading cause. Evaluation of key HAI determinants allows understanding on the relative importance of each factor towards HAI emergence.

Initial research suggests that HCWs exert influence towards HAI rates, so the next question

probes for reasons to either justify or invalidate HCWs as an identified main cause of HAIs. Question 3 examines various HAI preventive measures currently in place, while the last question assesses faults in interventions against HAIs for recommendations to improve on these measures.

This report will analyse information from secondary sources in relation to the aforementioned key questions in the investigation, before reviewing primary sources obtained through communication with experts. Positions toward the point at issue will then be presented and assessed for a conclusive final position, with final comments.

Supplementary information will be included as appendices thereafter.

Investigation of Research Questions

1. Which is the major factor in causing HAIs?

Infections are complex in nature, as they arise from multiple causes and vary in severity, depending on an individual’s own immune response. Particularly for HAIs, it is tough to narrow down specific causes as HAIs arise from an interrelationship between