Healthcare-Associated Infections as the Quality Safety Problem

Healthcare-Associated Infections as the Quality Safety Problem

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Healthcare-Associated Infections as the Quality Safety Problem


Healthcare-associated infections have become a contemporary issue in healthcare delivery in hospitals. It occurs when modern medical devices get applied by doctors and medical officers while treating patients but causing diseases and infections. Majorly, infections occur after surgical procedures, making patients suffer from several illnesses. Common illnesses that occur through healthcare-associated infections include central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections. An individual doctor should work towards preventing any associated infections during service delivery to the patients. Therefore, the paper analyses the common types of healthcare-associated infections, their potential solutions, and the personal impression regarding the infections based on past learning experiences and the course content.

Central Line-Associated Bloodstream Infections

Central line-associated bloodstream infections occur when the bloodstream gets infected by the germs which enter through the central line. It is also an infection that is laboratory confirmed by the doctors but has no relationship with the infection being treated hence developing within forty-eight hours of the central line placements. Thousands of deaths have occurred in the medical field due to central line-associated bloodstream infections. As such, it has led to a medical burden. Notably, most infections are preventable through several measures. The common central line-associated bloodstream infections include gram-positive organisms, which are the coagulase-negative staphylococci, Staphylococcus aureus, and enterococci (Haddadin & Regunath, 2019). Also, the gram-negative related to central line-associated bloodstream infections are the Pseudomonas, Acinetobacter, Candida, and Enterobacter.

Consequently, central line-associated bloodstream infections lead to a prolonged hospital stay in patients, increasing healthcare costs. Same e infections are related to the presence of intravascular devices. In the United States of America, 0.081% of healthcare-associated infections occur as central line-associated bloodstream infections. Also, they are found outside the intensive care units (Haddadin & Regunath, 2019). Most importantly, the risk factors which intensify central line-associated bloodstream infections are chronic illnesses like gastrointestinal tract disorder, malignancy, hemodialysis, and pulmonary hypertension.

Also, the immune suppressed states like diabetes mellitus and organ transplant, malnutrition, total parental nutrition, prolonged hospitalization before the insertion of the central line, extreme age, and skin burn intensify the infections. Femoral central venous continues to escalate the central line-associated bloodstream infections, followed by the subclavian catheters and the internal jugular. Other associated risk factors include the conditions of the insertion of the medical operations, the skillful nature of the operators, and the catheter care. With prolonged administration of broad-spectrum antibiotics, hematologic malignancy creates resistance to the anti-microbial therapy (Haddadin & Regunath, 2019). The clinical manifestation of central line-associated bloodstream infections varies based on the state of the illness. The common manifestations include fever and chill, which are masked by the patient’s immune-compromise nature. The patient may also report pain, discharge from the exit site, and swelling.

Potential Solution of the Central Line-Associated Bloodstream Infections

After the suspecting central line-associated bloodstream infections, empiric therapy should be administered based on the most probable organism and the clinical picture. The healthcare provider should institute empiric treatment by covering the gram-positive and the gram-negative. Healthcare providers should also enhance hand hygiene and apply appropriate skin antiseptic for prevention. The sin prep agent should be completely dry before inserting into the central line (Haddadin & Regunath, 2019). During the insertion, the healthcare provider should use the cap, the mask, sterile glove, sterile gown, and the sizeable sterile drape. The patients should research the hospital to learn about central line-associated bloodstream infections. They should also speak on the concerns to enable the healthcare personnel to follow the appropriate precaution for mitigating the detriment. Avoiding ouches on the tubing by the patient will create a hygienic environment hence preventing infections (Haddadin & Regunath, 2019). Every patient must wash her hands before and after visitations.

The Catheter-Associated Urinary Tract Infections (CAUTI)

Catheter-Associated Urinary Tract Infections are illnesses acquired in hospitals and occur due to the prolonged use of urinary catheters. The infections affect the urinary systems like the bladder, uterus, kidney, and urethra. As such, the illness gets referred to as urinary tract infections. The tube insertion into the bladder through the urethra to drain the urine has caused 75% of the infections. The infection occurs in the patients admitted to the intensive care unit hence the prolonged hospital stay makes control difficult. The common etiological agents are the gram-positive bacteria like the Enterococcus faecalis and the gram-negative bacteria like the Pseudomonas species and the Proteus mirabilis (Su et al., 2020). Healthcare providers frequently report Yeast infections like the candida species. Common drug resistance development, which occurs with urinary tract infections, has led to the growth of pathogens. Other causes include extreme age, the female gender, diabetes mellitus, dwelling urinary devices, and immunosuppressive therapy.

Potential Solutions to the Catheter-Associated Urinary Tract Infections

Healthcare providers should enhance hygiene by hand washing and avoiding the use of urine drain tubes. If the urine drains tubes are used by the doctor, they shod be appropriately inserted and put in only, when necessary, as soon as needed. The core preventive strategies are leaving the catheters in place when needed, ensuring that the trained catheters implement the insertion and the maintenance of the catheters, following the aseptic insertion and maintenance of the hand and the standard hygiene (Su et al., 2020). The doctors should also avoid using urinary catheters in nursing homes and inpatients for incontinence management. Healthcare providers must research before using catheters to prevent skin breakdown. Medical service providers should consider using external catheters to replace indwelling catheters for male patients with no urinary retention. The healthcare providers should maintain the unobstructed urine flow and follow the aseptic insertion while maintaining the closed drainage system (Su et al., 2020). Furthermore, healthcare service providers should use sterile gloves, drapes, sponges, and sterile solutions to clean the peri-urethral.

Ventilator-associated Pneumonia

Ventilator-associatedPneumoniaa isPneumoniaa acquired from e hospital through the use of ventilators. It occurs 48 hours after the mechanical ventilation, where the ventilator has a high mortality rate. It causes the patient to have challenges with weaning off the ventilators and longer duration of the hospital stay (Wanat et al., 2020). Therefore, it causes a financial burden and the demand for medical resources. Ventilator-associated pneumonia symptoms are fever, worsening oxygenation, increased tracheal secretions, and an increase in white blood cell counts. The diagnosis is based on the clinical presentation, positive blood culture, and chest x-rays. Bronchoscopic sampling in the lower respiratory tract combined with the quantitative gram strains and culture helps diagnose. Treatment is made using antibiotics (Wanat et al., 2020). The risk factors include endotracheal intubation, which beaches the airway’s defenses, impairing the mucociliary clearance and facilitating the microaspiration of the bacteria-laden secretin. Consequently, bacteria may form the biofilm within and on the endotracheal tube, which protects them from the host defense and the antibiotics. The common pathogens include pseudomonas aeruginosa and the methicillin-sensitive Staphylococcus aureus.

Potential Solutions for the Ventilator-associated Pneumonia

Upright positioning reduces aspiration compared to recumbent positioning; hence, doctors should consider using semi-upright positioning during service delivery to the patients. Healthcare providers should also use noninvasive ventilators with continuous positive airways and bi-level positive airway pressure to prevent the beaching of the airway defense, which may occur with endotracheal intubation (Wanat et al., 2020). Also, the repeated aspiration of the subglottic secretin through a designed endotracheal tube with a suction device to reduce the microaspiration and VAP incidents prevents infections. Moreover, decontamination of the oropharynx using colistin, gentamicin, and vancomycin cream should be voided due to the possibility of developing resistant strains.

The Personal Impression Regarding the Infections based on the Past Learning Experiences and the Course Content

As a student of healthcare, the healthcare patient safety course has enabled me to understand healthcare-associated infections. Understanding the healthcare-associated infection has created comprehensive knowledge through which I can determine the symptoms associated with the ventilators associated pneumonia, catheter-associated urinary tract infections, and central line bloodstream infection. Also, the study and the identification of healthcare patient infection has created a mechanism of conceptualizing the ideas which help determine the possible solutions. The possible standard solutions to combined healthcare patient infections are the maintenance of hygiene, like washing hands and using appropriate medical procedures. Notably, past learning provides the knowledge through which I can quickly determine the instances of healthcare-associated infections. The safety of medical procedures and medical machines and instruments like ventilators play a significant role in enhancing medical sustainability and delivering medical services.


Haddadin, Y., & Regunath, H. (2019). Central line-associated bloodstream infections (CLABSI). StatPearls. StatPearls Publishing.

Su, M., Jia, Y., Li, Y., Zhou, D., & Jia, J. (2020). Probiotics for the prevention of ventilator-associatedPneumoniaa: a meta-analysis of randomized controlled trials. Respiratory care, 65(5), 673-685., M., Borek, A. J., Atkins, L., Sallis, A., Ashiru-Oredope, D., Beech, E., … & Tonkin-Crine, S. (2020). Optimizing interventions for catheter-associated urinary tract infections (CAUTI) in primary, secondary, and care home settings. Antibiotics, 9(7), 419.