Hospital Pharmacist
2008;15:7-12
January 2008

Healthcare-associated infection — hospital-acquired infection

By Conor Jamieson, PhD, MRPharmS

Healthcare-associated infections represent a massive challenge currently facing the NHS. Pharmacists must play their part in the management of infected patients and be aware of strategies that prevent one infection becoming an outbreak

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SUMMARY

Recent outbreaks of uncontrolled healthcare-associated infection (HCAI) have demonstrated the devastating impact that such infections can have on the health services operationally, politically and in terms of patient morbidity and mortality.

HCAIs are defined as infections acquired while in hospital or because of healthcare interventions. This article focuses on hospital-acquired infections — those that develop as a result of exposure to organisms that thrive in a hospital environment.

However, if the infecting organism is introduced to the body by an invasive healthcare intervention, it is considered an intervention-related infection. This is discussed separately (p13).

A hospital-acquired infection is one that develops at least 48 hours after a patient is admitted to hospital, or up to 48 hours after discharge. Outside this period, infections are considered to be community-acquired.

Political drive Controlling HCAIs is a key focus for the Department of Health, which in 2004, announced a target to halve the national incidence of MRSA (meticillin-resistant Staphylococcus aureus) infections by 2008 (based on figures for 2003).

Guidance on reducing HCAIs has been published by the DoH and trusts are now required to produce frequent reports on HCAI incidence rates. Another HCAI that will be included in these reports is Clostridium difficile-associated diarrhoea, for which the national incidence is continuing to increase.

The inclusion of the Hygiene Code in the Health Act 2006 placed a legal requirement on NHS managers to prevent and control HCAIs, and provided criteria to ensure a clean environment for patients, in which the risk of HCAIs is as low as possible.

However, working to prevent and control HCAIs is the responsibility of all members of the healthcare team.