By Greg Miziolek
Hospital-acquired infections, sometimes referred to as healthcare-associated infections (in both cases, HAIs) are the most frequent adverse events affecting patients in hospitals around the world.1 In Canada, more than 200,000 patients contract HAIs per year.2 Common types of HAIs can include urinary tract infections (UTI), blood stream infections (BSI) including central line-associated bloodstream infections (CLABSI), and can be caused by organisms such as Clostridioides difficile (C. diff) and methicillin-resistant Staphylococcus aureus (MRSA).2 In a time when our hospitals are already battling the COVID-19 pandemic, measures to limit the risk of these infections, along with preserving the associated resources to manage them, is especially vital.
While any HAI may be detrimental for a patient, infections by antimicrobial-resistant organisms, like MRSA, can be particularly concerning, especially as patients face existing infections, injuries or chronic conditions.3 While the rate of HAIs in Canadian hospitals is fortunately declining, the number of infections caused by organisms with antimicrobial resistance (AMR) is increasing and over 50 per cent of HAIs are resistant to at least one antibiotic.4,3
In the most dire cases, HAIs can be fatal.3 In other cases, they can result in prolonged hospital stays, long-term disability and additional costs for families and patients.1 Healthcare workers are also impacted by HAIs, as special control measures must be taken when treating an individual with a resistant infection, requiring time and resources. On a broader scale, HAIs also take a financial toll on our public health system: in 2012, costs to manage the estimated 37,900 C. diff episodes in Canada amounted to approximately $281 million.2
With the use of sophisticated surveillance tools, hospital teams can identify, track and report resistant infections when and where they occur. Policies such as mandatory reporting can support more frequent data collection and insight generation. Consistent and comprehensive reporting through normalization of data can also support extensive benchmarking, allowing hospital administrators and governments to observe the impacts of strategies to combat HAIs.
Canadian institutions may also find they spend considerable time manually engaging in these requisite reporting obligations. Adoption of automated surveillance tools has been helpful across numerous health systems, including Hackensack Meridian Health–JFK Medical Center, an example of a hospital that has seen great success in their efforts to combat HAIs. After identifying an increase in the number of C. diff infections in December 2016, a steering committee of key stakeholders was tasked with developing a strategy to reduce the rates of this resistant infection. Their plan involved utilizing the BD HealthSight™ Clinical Advisor and Infection Advisor with MedMined™ Insights (formerly MedMined™ Surveillance Advisor) technology, as well as a review of current protocols and practices for infection prevention. The BD software aggregates and standardizes patient data to empower clinicians to intervene with at-risk patients, determine trends on infection types and facilitates benchmarking within a hospital or region. With use of the surveillance tool and guidance from the BD team, Hackensack Meridian Health–JFK Medical Center implemented daily huddles using mobile tablets to increase collaboration and information sharing, trained all front-line staff on new infection-prevention protocols and ensured appropriate testing allocation based on where symptoms suggested such tests were most needed. Within a year, Hackensack Meridian Health–JFK Medical Center saw a reduction of C. diff cases by 48%.5
By re-evaluating current practices and finding opportunities to improve current protocols, hospital teams can drastically reduce the rate of HAIs, benefitting patients, healthcare workers and entire hospital systems. With adequate infection prevention and control programs and strategies, hospital teams can better protect patients by reducing infections and supporting better outcomes.
To collaborate with us and learn more about AMR, visit: go.bd.com/learnmoreAMR
Greg Miziolek is President, BD Canada.
1. World Health Organization. “The burden of health care-associated infection worldwide.” 2020. https://www.who.int/infection-prevention/publications/burden_hcai/en/. Accessed July 2020.
2. Government of Canada. “Evaluation of Healthcare-Associated Infection Activities at the Public Health Agency of Canada 2012-13 to 2016-17.” 2018. https://www.canada.ca/en/public-health/corporate/transparency/corporate-management-reporting/evaluation/healthcare-associated-infection-activities-2012-2017.html##es. Accessed July 2020.
3. Government of Canada. “The Chief Public Health Officer’s Report on the State of Public Health in Canada 2013 – Healthcare-associated infections – Due diligence.” 2013. https://www.canada.ca/en/public-health/corporate/publications/chief-public-health-officer-reports-state-public-health-canada/chief-public-health-officer-report-on-state-public-health-canada-2013-infectious-disease-never-ending-threat/healthcare-associated-infections-due-diligence.html. Accessed July 2020.
4. Jennie Johnstone, Gary Garber and Matthew Muller. “Health care-associated infections in Canadian hospitals: still a major problem.” 2019. https://www.cmaj.ca/content/191/36/E977. Accessed July 2020.
5. BD. “BD MedMined™ Surveillance Advisor case study.” 2019.