Healthcare Associated Infections (HAIs)
Evidence-based practice is used to prevent and control HAIs.
In the US, an estimated 5-10% of hospitalised patients experience a HAI every year, resulting in substantial morbidity and mortality.1
In Australia, it is estimated that 200,000 HAI occur annually.2
- Central line-associated bloodstream infection (CLABSI) Approximately 4000 episodes in Australian intensive care units each year. Mortality rate of 4–20% with estimated cost of $36.26 million.3
- International Nosocomial Infection Control Consortium (INICC) surveillance data from January 2010 through December 2015 (703 intensive care units in 50 countries) reported a CLABSI rate of 4.1 per 1000 central line days.4
- One systematic review and meta-analysis regarding HAIs in Southeast Asian countries (Brunei, Myanmar, Cambodia, East Timor, Indonesia, Laos, Malaysia, the Philippines, Singapore, Thailand, and Vietnam) found an overall prevalence rate of 9.1% with the most common microorganisms being P. aeruginosa, the Klebsiella species, and Acinetobacter baumannii.5
Lung Ultrasound - COVID-19 Response – Cross-Infection Risk
Thoracic ultrasound has rapidly gained popularity in emergency and trauma settings.
Ultrasound circumvents many of the issues that arrive with traditional radiography, such as:
- Delay of care
- Radiation exposure.
- In an unstable patient, who is unfit for extended delays due to transport to the CT scanner or even bedside chest radiography, bedside ultrasound is readily available to physicians.
Ultrasound can detect the pulmonary changes associated with pneumonia (COVID-19)6
ACEM COVID19 Guidelines: To minimise requirements for intra-hospital transport to radiology, consideration should be given to the utility of bedside point of care ultrasound (POCUS) for chest investigation where the skill set is available.7
- Lung Ultrasound surface probe cross-infection risk
COVID-19 Viruses can survive in the environment or on surfaces for periods of time (few hours or up to several days).
- Transmitted via air, droplets, body fluids and contact with surfaces.
U.S. Department of Health & Human Services. National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination. April 2013. http://1.usa.gov/1KycQcM
Edwards VR. Preventing and managing healthcare‐associated infections: linking collective leadership, good management, good data, expertise, and culture change. J Hosp Infect 2016; 94: 30–1.
Entesari‐Tatafi D, Orford N, Bailey MJ, Chonghaile MN, Lamb‐Jenkins J, Athan E. Effectiveness of a care bundle to reduce central line‐associated bloodstream infections. Med J Aust 2015; 202: 247–50.
European Centre for Disease Prevention and Control (ECDC) http://www.ecdc.europa.eu/en/Pages/home.aspx
. Ling ML, Apisarnthanarak A, Madriaga G. The Burden of Healthcare-Associated Infections in Southeast Asia: A Systematic Literature Review and Meta-analysis. Clin Infect Dis. 2015;60(11):1690–1699. [PubMed] [Google Scholar]
Scott, RD. The Direct Medical Costs of Healthcare-Acquired Infections in US Hospitals and the Benefits of Prevention, Centers for Disease Control and Prevention. 1–13, 2009.
P.Cameron, J. Bonning, et.al; ACEM COVID19 Guidelines. 24 April 2020.