The term Nosocomial Infection has more recently been changed to Health Care Acquired Infection or HAI. I find Health Care Workers continue to default to using Nosocomial. In any case, a HAI or Nosocomial Infection, is one that develops 48 to 72 hours after admission to a healthcare facility, according to McGeer’s Criteria (McGeer’s, 1991)

Multiple factors contribute to the transmission of infectious organisms in hospitals, long-term care facilities and rehabilitation centers; they include the type of infectious organism, the patient’s proximity to the source of infection, the means by which the organism could potentially be transmitted  and the status of the patient’s immune system.

Ultimately, it is the responsibility of the facility to develop policies and procedures designed to interrupt the transmission of infectious organisms from the source to the patient and to maintain a strong Infection Control Surveillance program. That is where you, the DSD, Infection Preventionist, or DON,  and your Infection Control Committee, come  in. Preventing HAI in Healthcare Facilities CDC

References:

McGeer A, Campbell B, Emori TG, Hierholzer WJ, Jackson MM, Nicolle LE, Peppler C, Rivera A, Schollenberger DG, Simor AE, Smith PW, Wang E. Definitions of Infection for Surveillance in Long Term Care Facilities. American Journal of Infection Control 1991; 19(1):1-7.

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Photo Credit: Janice Haney Carr, Centers for Disease Control and Prevention

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Photo Credit: Janice Carr, Centers for Disease Control and Prevention

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In the past, the term Nosocomial Infection was used to describe facility acquired infections; the newer term, Healthcare-associated Infections (HAI) is in use by Preventionists now.

In our last post we discussed many of the duties assigned to the ICP. One of the most important responsibilities is the surveillance program, which is a means of collecting patient data as it pertains to infection prevention and control.

Pertinent information about newly diagnosed infections, the clinical signs and symptoms supporting the diagnosis, and new orders for antibiotic treatments are reported on surveillance logs and then analyzed.

APIC and McGeer defines a Healthcare-associated infection (HAI) as one that develops more than 48 hours after admission. Conversely, a Community–associated infection is one that was present on admission or developed with-in 48 hours of admission.

A chronic infection is one present at the same site from 1-3 months. These are monitored by the ICP and nursing staff as are all other infections, but for the purposes of statistical reporting they are referred to as chronic rather than Healthcare-associated infections.

For statistical reporting McGeer’s Definitions of Infection for Surveillance in Long-term Care Facilities are generally recommended as a resource for analyzing and quantifying patient’s signs and symptoms. This information, in combination with reviewing of cultures and sensitivities, drug resistant organisms and anti-biotic usage, is recommended for monitoring and reporting infection rates.