In early 2014 one of our blogs described what we believe the future hospital
will look like. We indicated that the patients requiring hospitalization
would be those with critical illness, injuries, or immediate post-op from
complex surgeries in the neurosurgical, cardiac, and transplant fields.
We added that because of the severity of these patients’ conditions,
they would be prone to hospital infections, which would significantly
increase over the next decade.
Validating these predictions was a recent article on the front page of
the Dallas Morning News in which the reporter, Jim Landers, included recent
statistics on hospital acquired infection rates. According to the U.S.
Centers for Disease Control and Prevention, one in 25 hospital patients
today come down with an infection picked up inside the hospital. In 2011,
an estimated 722,000 patients acquired one, and more than 75,000 dies,
either from an infection or because the infection weakened a person’s
ability to fight their other illnesses. The reporter went on to explain
that these are alarming numbers, but they have gone down since the 1970’s
when an increased emphasis controlling hospital infections was pushed
by both governmental and private hospital systems.
However, in light of this decrease in numbers, the infections that are
occurring are often more difficult to treat. Bacteria are becoming more
virulent as they mutate to become resistant to the increasing number of
antibiotics that are often utilized excessively, and in some cases, unnecessarily,
An example of such would be the outbreaks of clostridium difficile, a
diarrhea-causing bacteria that gets a grip on a person’s gut when
antibiotics kill off the bacteria that normally lives in a person’s
intestines. C. difficult is resistant to many antibiotics and kills 14,000Americans
Realities in the infectious disease world today when combined with the
increasingly sicker patients that will be treated in outpatient clinics
and hospitals in the future, will increase the number of extremely serious
and life-threatening diseases. These diseases are quickly transmitted
from patient to patient if appropriate preventive measures are not adopted
by all healthcare workers. This was validated most recently by observing
the course of the Ebola cases treated in U.S. facilities. If such serious
infections ever become outbreaks on American soil, the challenges form
infections will be significantly magnified.
So, what must our response be as workers in the healthcare field?
- First and foremost, we must make sure all the processes and procedures
remain in place consistently that have reduced overall infection rates
in hospitals since the 1970’s.
- Every patient seeking care must be seen as a potential infected patient,
and all care givers need to be on the alert at all times for the signs
of pending infections, including fever, lethargy, or the patient merely
saying, “I am not feeling as well today as I did yesterday.”
- Providers should use antibiotics only when necessary and indicated by evidence-based
- Patients and families should not demand antibiotics if they trust their
providers who are providing clear rationale of why such are not necessary.
- If a patient is suspected of being infected, he or she should be placed
in isolation immediately until an infection is ruled in or out.
- Infection related data should be collected and kept current, reviewed periodically
to gain knowledge to improve and update infectious disease protocols.
Infections have been the cause of death in many patients since the beginning
of time. Although the overall numbers are declining, the severity of infection
is increasing. And it is only expected that this severity will grow, making
each case more and more difficult to treat, Hence, like much in healthcare,
prevention is the key. This means that because of the possibility of an
infection in each and every patient caregivers must be ever mindful and cautious.