Ireland has a higher rate of healthcare-associated infections than the US, writes Quynhvi Vu
Healthcare-associated infections (HAIs) are infections that people acquire in the healthcare setting while undergoing treatment for another condition.1 These settings include hospitals, outpatient settings and long-term care facilities. According to the World Health Organization, HAIs are the most common complications in healthcare delivery worldwide.2
In addition, millions of patients are affected by HAI annually, leading to mortality and financial losses for health organisations. This paper will compare and contrast HAIs in Ireland and the US. In comparing this issue between the two countries, the following questions will be addressed:
Rate of HAIs
HAIs are prevalent in healthcare settings
in both the US and Ireland. In the US
the prevention, reduction, and elimination
of HAIs is one of the goals for Healthy People
2020.3 This Healthy People 2020 goal
indicates that HAI is a major public health
concern that needs to be addressed. As of
2002, the US has an estimated 4.5% incidence
rate for HAIs.2
These infections result in nearly 90,000 deaths per year.4 A national survey showed that the prevalence rate of HAIs in Ireland is 5.2%.5 This indicates that an estimated one-in-20 patients has a HAI. Analysing the data above, Ireland has a slightly higher rate of HAIs than the US.2,4,5 Despite the differences in HAI prevalence rates, it is clear that this issue affects both countries.
Most common infections
The most common types of infections
seen in healthcare settings are similar in
both countries. In the US, a majority of
HAIs include: pneumonia, surgical site
infections (SSI), urinary tract infections
(UTIs), and bloodstream infection.1 In Ireland,
the common types of infection are:
pneumonia, SSI, UTIs, bloodstream infections,
and gastrointestinal infections.5
In both countries, the prolonged use of
catheters contributed to UTIs; and central
venous catheters put patients at risk for
bloodstream infections.
When patients acquire infections they are given antibiotics for treatment. Although antibiotics are effective in the treatment of infections, their use puts patients at risk for developing antibiotic resistance such as methicillin-resistant Staphylococcus aureus (MRSA).6 Antimicrobial resistance can cause severe problems such as the HAIs listed above.
Contributing factors and prevention
Both Ireland and the US share the same
contributing factors for HAIs. Risk factors
include: surgical procedures, excessive or
improper use of antibiotics, contaminated
healthcare setting, and use of indwelling
medical devices.1 It should also be noted
that the behaviours of healthcare providers
in the healthcare setting influences
the rate of HAIs.
HAIs affect millions of people annually, but it is easily preventable. In Ireland, the Health Protection Surveillance Centre states that healthcare workers can take the following preventive measures: compliance with hand hygiene, understand the significance and impact of antimicrobial resistance and HAI, and implement plans to prevent infections associated with medical devices.5 Healthcare facilities in the US are also advised of similar preventative measures. Research has shown that proper education and training of healthcare workers results in increased compliance with and adoption of practices to prevent these infections.7
Educational and training programmes included careful use of antibiotics and proper hand hygiene.
Financial implications
Not only are HAIs a significant cause
of morbidity and mortality, they are also
a financial burden for healthcare facilities
in both the US and Ireland. In the US,
the overall annual medical costs of HAI
to hospitals ranges from $28.4 to $45
billion.8 The cost to treat SSI and catheterassociated
urinary tract infection (CAUTI)
for each patient averages around $10,400
and $760, respectively. If proper infection
control interventions are taken, US health
care facilities can save anywhere from
$5.7 to 31.5 billion, annually.8
In Ireland, the annual medical cost to treat HAIs in each hospital is €1.75 million. 9 By taking preventive measures, each hospital would save €530,000 each year. Looking at the staggering financial costs HAIs have on healthcare facilities in both countries, developing and implementing prevention interventions would benefit healthcare organisations by saving them millions to billions each year.
HAIs are important issues that affect both Ireland and the US in the healthcare setting. Based on the given data, Ireland has a slightly higher prevalence rate of HAIs than the US: 5.2% versus 4.5% respectively. The major types of HAI affecting patients are the same for both countries. In addition, Ireland and the US share the same contributing factors for HAIs. Recommended preventive measures for HAIs include staff education, clean environment, and hand hygiene. HAIs are a huge financial burden for both countries; each year hospitals lose anywhere from millions to billions of euro each year. HAIs are preventable and initiating interventions would benefit healthcare organisations and their clients.
Quynhvi Vu is a nursing student at California State University, Channel Islands. She recently completed an intense two-week course, learning about Irish nursing, in Trinity College Dublin’s School of Nursing and Midwifery
References available on request from nursing@medmedia.ie (Quote Vu, Q: WIN 2014; 22(6) : 50)
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