On nosocomial infections: How hospitals can cause infections

The hospital, inasmuch as it is a place meant for recovery from illnesses, can be a source of disease all the same. In fact, if healthcare providers fail to adhere to principles of asepsis, patients under their care may just acquire nosocomial infections during the course of their hospital stay.

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Nosocomial infections, also known as hospital-acquired infections (HAIs), are infections which patients contract while they are inside the hospital facility for medical treatment. As many as 1 out of 20 hospitalized patients contract nosocomial infections, thus resulting to complications that lead to unwanted protraction of hospital stay.

Nosocomial infections are most commonly found in three forms:

• Catheter-related bloodstream infection. Most commonly found in intensive care units, these are infections caused by different types of bacteria that found their way into the bloodstream through peripheral and central lines.

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• Hospital-acquired pneumonia (HAP). As opposed to “community-acquired pneumonia (CAP)” which occurs before or a short time after admission, HAP is a lung infection that occurs 48 hours or longer after admission to a healthcare facility. This type of pneumonia tends to be more serious, as the patients’ immune systems are often compromised, making it harder for them to fight back the infection.

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• Surgical site infection (SSI). It is a post-surgical infection that occurs in the body part where the surgery was performed. It is usually caused by opportunistic transient flora (bacteria that colonize the host in certain areas but not cause disease) that manages to enter the surgical wounds. While some of these infections are only skin-deep, some manage to seep deeper, reaching deeper tissues such as visceral organs, bones, and even implanted material such as hip replacements.

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The faces of risks in surgical patient management

Patient safety is considered a serious public health issue worldwide. In fact, the World Health Organization shows that 1 out of 10 patients is harmed under hospital care even in developed countries. This shows that risks are inevitable, specifically during surgical procedures. Thus, the assessment of risks is crucial so that physicians can perform their duties effectively and make consensual decisions for whatever surgical procedures they perform.

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In this light, tests are used in calculating or stratifying risks for patients undergoing surgery, especially in myocardial problems. This is summarized as follows:

1. General preoperative risk stratification

2. Preoperative risk stratification for myocardial events

3. Postoperative risk stratification

The purpose of this scoring system is to identify potential high-risk patients and focus on generating a multi-level risk-and-benefit discussion among hospital practitioners.

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Risk is a term that comes in many forms, depending on the expectation and experience of varying patient groups. In understanding and identifying these risks, there are methods to utilize. In integrating these methods concurrently with proper implementation, risk management could improve significantly. As a result, medical practitioners and healthcare executives, like Dan Bucsko and Kurt Weinmeister, can perform their duties well in improving the quality of care for all patients, and risks, such as prescription error, injurious fall, improper documentation, adverse anesthesia effects, and even death, could ultimately be avoidable.

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