Any medical professional working with seniors in a skilled nursing home setting knows the impact a Healthcare-Associate Infection (HAI) (sometimes call “hospital acquired infection”) can have on a senior. For those unfamiliar with the phrase, an HAI is when someone develops an infection at a hospital or other patient care facility they did not have prior to admission. In other words, they were admitted to a facility for some condition and while there, contracted an infection they may have otherwise not acquired. Registered nurses working in long-term care know the prevalence of HAIs as they wonder each time they send a resident to the hospital if they’ll come back potentially worse than when they left.
The problem is serious. According to the World Health Organization, at any given moment, 1.4 million people worldwide are suffering from infections acquired in a hospital. The U.S. Centers for Disease Control (CDC) estimated that nearly 100,000 people died in 2002 as a result of HAIs. Beyond patient implications, HAIs also contribute to the overall cost of healthcare delivery as individuals often get readmitted to a hospital or need to stay longer in a skilled nursing facility. Seniors are particularly susceptible to HAIs as many have reduced immunity to infections.
There is now a renewed focus on quality of care. Health advocates have been pushing for HAI changes for years. The U.S. health care reform initiative aims to reduce in incidence of HAIs by punishing or rewarding health care providers. Here are some of the changes:
- Starting in October 2012, non-rural acute care hospitals that meet performance standards for at least five measures will receive higher Medicare payments. These measures include certain hospital-acquired infections.
- Starting in October 2012, hospitals with high readmission rates for patients with these conditions will have their Medicare payments reduced. Each hospital’s record for these conditions will get published.
- The health reform law expands Medicare’s policy of denying payments to hospitals for extra care required to treat certain preventable infections to Medicaid payments.
- Starting in October 2014, the Department of Health and Human Services will reduce Medicare payments by 1% for hospitals with the highest rates of medical harm.
- By 2012, health insurance providers must include quality improvement measures in contracts with health care providers that include measures to reduce hospital readmissions and improve safety.
Kimberly-Clark, a company that markets products and services to health professionals, has launched an “HAI Watchdog Community”to assist professionals prevent HAIs. The site allows participants to participate in discussions, access articles and share knowledge.
The CDC lists the following infectious diseases as potential HAIs (source):
- Bloodborne Pathogens
- Burkholderia cepacia
- Clostridium difficile
- Clostridium sordellii
- Creutzfeldt-Jakob Disease (CJD)
- Gastrointestinal (GI) Infections
- Hepatitis A
- Hepatitis B
- Hepatitis C
- MRSA – Methicillin–resistant Staphylococcus Aureus
- Pneumonia Rubella
- S. pneumoniae (Drug resistant)
- Varicella (Chickenpox)
- Viral Hemorrhagic Fever (Ebola)
- VISA – Vancomycin Intermediate Staphylococcus aureus
- VRE – Vancomycin–resistant enterococci