- Nosocomial infections are not complications caused by the illness or surgical procedure that resulted in the initial hospitalisation.
- In the vast majority of cases, nosocomial infections are not the result of medical or professional errors.
- Nosocomial infections are medical accidents that occur during treatment, and constitute an ever-present risk associated with hospitalisation.
In Québec alone, one in 9 hospitalized patients is a victim of such infections, resulting in 90 000 cases and 4000 deaths annually.
In Canada, one in nine Canadian patients admitted to hospital each year will acquire an infectious disease. Experts in infection control estimate that hospital infections will kill 8,000 to 12,000 Canadians each year» (nidd.ca, Oct. 2008).
This high rate is unacceptable because up to 90% of these infections are preventable, and can be avoided with proper prevention and control measures. Hospitals and all health care centers have the legal responsibility to provide all the necessary resources - human, material and financial - in order to ensure safe, quality health care.(RID organisation). «Infections associated with healthcare are one of the most significant infectious disease challenges.» (nidd.ca, oct 2008)
Nosocomial infections place a substancial burden on individual patients, their families, and the health care system. Higher death rates, longer and more costly hospital stays, reduced physical capacity including long term disability, loss of income, heavier work load for health care workers etc...
Such infections have existed as long as hospitals.
The origin of the word «nosocomial» can be traced to the Latin word «Nosocomium», which means hospital, and the Greek word «Nosokomeion».
During the middle ages, hospital infections were considered to be divine wrath. In the 12th Century for example, the Church persecuted Theodore of Bologna as a heretic for suggesting that medical procedures were the cause of diseases and infections. In the 17th Century, nosocomial infections were attributed to particles circulating in the air of hospitals. Improving hospital ventilation systems was thought to be the solution. Late in the 19th Century, Louis Pasteur discovered that germs or bacteria were the cause of nosocomial infections and demonstrated the importance of ensuring that conditions were sterile, or free of disease causing micro-organisms.
NIs increase constantly: why?
- Bacteria, as all leaving species, have an extraordinary capacity to adapt to their environment. They have become resistant to antibiotics, and consequently are increasingly difficult to treat and eradicate. Many diseases such as tuberculosis, which have long been considered curable, are once again a cause for concern. New diseases such as AIDS or SARS have appeared.
- Due to medical progress, hospitals now treat patients that would have died in earlier times. Except Unfortunately, new or developing infections occur most frequently in people who have weakened immune systems such as older patients or patients in chemotherapy.
- Medical techniques have become more efficient but often more invasive with higher risk of infection.
Over the last three decades, the number of nosocomial infections has increased dramatically, and constitutes 30% of the «undesirable occurrences» that undermine patient safety and the quality of health care. Infection control reflects directly on the efficiency of any given hospital and its ability to provide safe, quality care.
Nosocomial infections are avoidable
With proper measures, 50% to 90% of nosocomial infections can be prevented. Proper hand hygiene by itself may reduce the NI rate by 50% within a year. Detection and prevention methods are well established and accessible. Essentially, the prevention of nosocomial infections is a question of properly managing human, material, and financial resources. Effective risk management is of the utmost importance.
The detection and prevention of nosocomial infections represent 25% to 30% of treatment costs. Preventing these infections will markedly improve the accessibility, safety, and quality of health care. Furthermore, the savings generated by such measures can be reinvested in the health care system.
Nosocomial infections: the most recent definition
«A nosocomial, or hospital-acquired, infection is a new infection that develops in a patient during hospitalization. It is usually defined as an infection that is identified at least forty-eight to seventy-two hours following admission, so infections incubating, but not clinically apparent, at admission are excluded. With recent changes in health care delivery, the concept of "nosocomial infections" has sometimes been expanded to include other "health care–associated infections," including infections acquired in institutions other than acute-care facilities (e.g. nursing homes); infections acquired during hospitalization but not identified until after discharge; and infections acquired through outpatient care such as day surgery, dialysis, or home therapy.»(1) In the case of surgery, the delay is extended to 30 days and up to one year for prosthesis or implants.
Hospitals and all health care centers should make infections prevention a priority. Their main responsability remains to deliver safe care to patients.
Read more:
Nosocomial infections: answers to your questions by Eric Rose - web site: «little facts»
(1)Answer.com - nosocomial infections
WHO - World Health Organisation - nosocomial infections prevention guide - 2nd edition
United-Kingdom Department of Health «a plan of action»
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