Healthcare-Associated Infections Equal High Costs

There is little doubt that Healthcare-Associated Infections (HAIs) can be devastating for both patients and facilities. According to the CDC, HAIs in U.S. hospitals have direct medical costs of at least 28.4 billion each year. In addition, HAIs account for 12.4 billion in costs to society from early deaths and lost productivity.[i]

It is not unusual to see patient dissatisfaction regarding HAIs sometimes resulting in a medical negligence claim. Although infection is a known risk associated with many healthcare procedures, the costs of defending these claims can be very high. Two recent claims involve infection occurring after pacemaker implantation.

Claim #1

A young female patient presented to the ED with a low heart rate and subsequently required pacemaker implantation due to a cardiac arrhythmia. She was given pre-op antibiotics before the procedure and antibiotic irrigation fluid was used during the implantation. She was discharged the next day, but later developed redness and swelling at the surgical site. The patient was readmitted with a presumed infection. Her wound culture grew Staph aureus and she required long-term antibiotics for several weeks.

The hospital had very specific protocols and quality measures in place for the prevention of surgical site infection. Protocols included education of the physicians and staff regarding proper antibiotic selection and timing of administration of pre-op antibiotics before incision. The Medical Review Panel opined that there was no evidence the patient’s infection was a result of substandard practices. Although the Medical Review Panel was favorable for all defendants, a suit has been filed. The case is ongoing.

Claim #2

An elderly patient with multiple co-morbidities presented to the hospital with symptomatic bradycardia, requiring pacemaker implantation. He was given pre-op antibiotics before the procedure and antibiotic irrigation fluid was used during the implantation.

After discharge the next day, he subsequently developed irritation and purulence at the surgical site and was diagnosed with a Staph aureus pocket infection. This infection required removal of the pacemaker, debridement of the site, and long-term antibiotics for several weeks.

The case is pending a medical review panel decision. Because the hospital documented proper skin preparation and proper timing of pre-operative antibiotics before incision, a favorable opinion is anticipated.

HAI Prevention

The prevention of healthcare-acquired infections (HAIs) has improved over the years despite about 1 in 31 hospitalized patients acquiring at least one HAI during their stay.[i] Healthcare providers do not intentionally cause HAIs and should remain vigilant by focusing on infection control data and practices.

Infection prevention measures should be hardwired into the following protocols:

• Ongoing staff training on infection control practices using competency-based training.
• Following evidence-based protocols such as CLABSI, CAUTI, SSI, and VAP protocols.
• Conducting infection control risk assessments on a routine basis; addressing identified opportunities for improvement.
• Routine monitoring of adherence to infection control practices by all staff members including physicians and mid-level providers.
• Utilize the National Healthcare Safety Network (NHSN) for HAI infection control data submission and tracking.
• Implement and hardwire a proactive Hand Hygiene program
• Standardized cleaning processes: Environmental, patient care equipment, and surgical equipment
• Ongoing monitoring of infection control patient data.
• Utilize an Environmental checklist for routine rounds.
• Conduct RCAs for identified HAIs.
• Conduct FMEAs on new patient care processes where HAIs might develop.

Learn More

LHA Trust Funds has a robust toolkit library that spotlights infection control practices. Learn more about infection control practices, how to evaluate your current infection control methods, and ways to improve infection control procedures and protocols with these toolkits:

Antibiotic Stewardship

COVID-19

Environment of Care

Hand Hygiene

High Reliability & Culture of Safety

Surgical Site Infection Prevention

[1] Centers for Disease Control and Prevention. (2021). Health Topics – Healthcare-associated Infections (HAI). https://www.cdc.gov/policy/pol...

[2] Centers for Disease Control and Prevention. (2021). Health Topics – Healthcare-associated Infections (HAI). https://www.cdc.gov/policy/pol...