HAIs are also 'human' associated infections
Don't lose the 'face' behind the rate
By Patti Grant, RN, BSN, MS, CIC
Infection Preventionist, Dallas, TX
Although we cannot move away from rates of healthcare associated infections (HAIs) especially in this age of HAI public reporting and transparency health care professionals might need reminding that people are represented in any HAI data calculated, statistically analyzed or distributed.
During general orientation I state, "Our job is not giving 'extras' to our patient while they are with us. They need to leave with what they bargained for, and not have the rude shock of a urinary, bloodstream, lung, or surgical infection. We don't need to share any extra pain and suffering".
While reading the November 2010 issue of Hospital Infection Control & Prevention ("Special Report: MRSA Patient Stories," pp. 122-128) which brought home the personal side of MRSA infections in our patients I was intensely aware of both perceptions and reality. Looking back it was obvious from the start what infection prevention and control was all about for those of us in the trenches it just took awhile for others to take up the passion to move forward as partners with our grass roots effort.
When family members suffer HAIs
On a personal note, my family has experienced several HAI events over the years. Although not a scientific study, let's just say they developed three surgical site infections out of fifteen procedures. I'm not too pleased with these less than stellar outcomes, yet I know full well that these HAI's were probably not "preventable" in the way a wrong-site surgery is a preventable "never-event." Did this make it any easier to watch the pain and suffering of family members? Watch them have repeated incision and drainage? Removal and replacement of hardware? A resounding "No" is the answer despite my science-based expectations of healthcare.
Working within health care and having these personal HAI experiences has centered my strong understanding of the unrealistic zero tolerance demands by some of those outside our infection prevention system. Keeping the humanity behind an HAI event can be a challenge. We cannot regress back to the days of only counting infections without the level balance field of comparative rates with risk-adjustment. So how can we keep the "face" behind the HAI?
- Include the numerator and denominator numbers when reporting rates, as this helps healthcare professionals see the number of people involved.
- Infection preventionists must give more real-time feedback on HAI surveillance. It is no longer sufficient to share findings at monthly or quarterly meetings. Share the actual event upon discovery. When bedside staff know about the HAI close to the occurrence they can review their practices and look for improvements.
- Encourage bedside staff to include a succinct social history when reporting on their HAI events. Hearing that "the patient is the father of three, with nine grandchildren" is very different than reporting "one total knee replacement infection".
- Engage the bedside professional in the investigation of an HAI event. I've heard many excellent approaches to the (literal) bedside review of HAI's by teams of professionals that are done within 48 hours of the HAI being identified. Physicians, nursing, respiratory therapists, etc, get involved as applicable.
I'm not in a teaching institution so I've settled on a combination of the above. For example, with central-line associated bloodstream infections (CLABSIs) I inform the staff upon discovery. The bedside staff does a review based on a set of questions, and then presents their findings at the next CLABSI Team meeting. It has worked well and is somewhat like providing surgeons with their own surgical site infection rates. The professionals reviewing the CLABSI data want to up their game and succeed. If you'd like a copy of the CLABSI review tool I use just e-mail me at [email protected] no reason to reinvent the wheel.
Although we cannot move away from rates of healthcare associated infections (HAIs) especially in this age of HAI public reporting and transparency health care professionals might need reminding that people are represented in any HAI data calculated, statistically analyzed or distributed.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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