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 every year.
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 protocols.
- 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.