Evolving Accountability with the Evolution of Infection Prevention

Francis Nwakire, MD and Yves Crehore, RN, ICP

On any given day in the US, about 1 in 25 hospital patients has at least one healthcare associated infection.  

Though the names of the pathogens and infections may change depending on where you are in the world, a stark reality remains constant from North America to Australia: these are risks that in-discriminately affect and take lives.  

When the CDC reports that 99,000 deaths in the US annually are linked to hospital-acquired infections (HAIs), it can become easy to lose sight of what that impact looks like on an individual level.  

In the summer of 2017, a new mother died of sepsis just six days after her son was born because providers failed to recognize the correct diagnosis. The case resulted in a landmark verdict and $20.6 million award.  

For infection prevention and control teams (IPAC), cases like this example get at the heart of the discipline, which is evolving quickly to keep pace with the increasing complexity of infections, the emergence of new pathogens and the challenges of increasing antimicrobial resistance.  

IPAC teams are experts trained in healthcare associated infections and antimicrobial resistance. A well-equipped team brings microbiologists, infectious disease doctors, pharmacists trained in antimicrobial stewardship and infection preventionists to the care continuum. They provide expert advice on the prevention of antibiotic resistance, spread of infection and effective antibiotic prescribing for the treatment of infection. Effectively, they equip all parties in healthcare with an essential understanding: how infections happen, how they can be controlled and what they mean to the organization and the patient.  

While education is a primary function of the IPAC team, they also develop, update and support audits of guidelines, best practices, regulations and policies. Additionally, IPAC teams undertake surveillance of HAIs and assist with the management of outbreaks through mitigation strategy and intervention design.  

But the IPAC team's job is only getting harder. This year's flu season was the worst in over a decade. Globalization is making once regionalized conditions, global problems. But some of the greatest pressure comes from much closer to home. According to Kaiser Health News, in 2017 US hospitals were expected to lose approximately $430 million dollars in funding through reimbursements for failing to prevent avoidable complications including infections, blood clots, bed sores, falls and the prevalence of drug resistant bacteria.  

These penalties are a catch-22. Failing to adequately address these avoidable complications leads to lower reimbursements, which in turn leaves healthcare organizations with less funding and fewer resources to provide care. As some healthcare organizations are learning, not addressing these issues ultimately leads to higher costs and liability.  

Evolving with infections  

Recently, in the Wall Street Journal the article What the Hospitals of the Future Look Like mused about a world where the healthcare infrastructure of today fades into history, replaced by smaller institutions and remote patient monitoring. One of the reasons for the speculation? Visiting hospitals means the risk of infections for patients and staff – and corresponding costs for healthcare organizations.  

While that future may be a distant dot on the horizon, many of the issues in infection prevention and control are far more tangible. According to a Frost & Sullivan analysis released this month, avoidable adverse patient safety events across the US and Western Europe - including HAIs, sepsis and diagnostic errors – could cost $383 billion by 2022. A senior research analysis was quoted in Becker's Hospital Review recommending that hospitals respond by directing resources into areas "with significant disruptive potential" including antibiotic resistance and sepsis.  

In the face of these types of predictions, IPAC teams continue to be tasked with the primary and essential function of keeping patients and staff safe. But they cannot do it alone. Last year, we surveyed infection preventionists to learn more about their role and how they could be better supported. The most common trends? More time, more help.  

The same concerns are echoed elsewhere. Manual surveillance work is incredibly tedious – and the more time members of an IPAC team spend crunching numbers, the less time they have to work on the floor, in care environments to put preventative measures in place.  

A study in the Journal of the American Medical Informatics Association concludes that early detection of possible intensive care unit acquired infections was "significantly enhanced" with the implementation of an automated surveillance system (reducing the workload to only 15% of the effort required for manual surveillance). Other reports echo that the right tools can help decrease the time spent on surveillance by up to 65%, enabling greater efficiency for IPAC teams and more time spend on preventative and interventional activities.  

What does that translate to? Safer care environments, less harm and fewer penalties.  

For more information, read our full infection prevention whitepaper, Unlock the IP Potential or learn about how our software can support your IPAC teams. And don't forget to share how your organization is approaching the evolving nature of infection prevention in the comments below.  


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