Fighting healthcare-associated infections

Ten out of every 100 patients in developing countries and six out of every 100 hospitalized patients in developed countries will acquire at least one infection whilst being treated.

Hence, HAIs leads to unnecessary suffering for individuals who are already in need of care and causes excessive costs for the healthcare system as well as to society at large. The costs of healthcare-associated infections are difficult to estimate on a global level. In the U.S. alone, however, the Centers for Disease Control and Prevention (CDC) has estimated the direct medical costs of healthcare-associated infections between USD 36-45 billion³⁶, which do not include indirect costs like lost productivity.

Up to 70% of the healthcare-associated infections can be prevented.

Another important factor adding to the toll of HAIs is the increase in antimicrobial resistance (AMR). More than 70% of bacteria causing HAIs are resistant to at least one of the drugs most commonly used to treat them.³⁷ HAIs are closely linked to AMR and are often caused by an increased risk of resistant strains of bacteria found in infections. Fighting HAIs is an important, preventive measure against AMR.

The good news is that up to 70% of the healthcare-associated infections can be prevented³⁸, and the most effective and cost-efficient way is to improve hygiene standards in hospitals and hand hygiene among healthcare workers³⁹. Apart from health benefits, investing in hand hygiene has a positive return on financial investment, as it is estimated at USD 24 for every USD 1 spent.⁴⁰

In theory, we know very well how to go about this. Building on Professor Didier Pittet’s research (interviewed later in this chapter) and the Geneva Hand Hygiene Model, WHO has identified five moments when healthcare workers should clean their hands.⁴¹ We also have a good understanding of how to successfully implement the best hand hygiene practices. Research and experience show that achieving long-term behavioral changes incorporates a combination of various strategies.⁴²

Some of the crucial elements include accessible infrastructure for hand rubbing and washing stations, and an understanding of the importance of hand hygiene among management and healthcare workers. Innovation also has an important role to play. Digital solutions that monitor compliance and provide feedback to healthcare workers are expected to gain progress in the near future. Another opportunity area is to ensure that hospital environment and medical tools have antimicrobial properties, such as antimicrobial spools for surgery tape, self-disinfecting textiles or better solutions for wound care.

We still have a long way to go before healthcare-associated infections are eliminated in patient care, and for all people with incontinence to lead dignified lives. In this chapter, we will explore what the path ahead looks like.