or septic shock. Bloodstream infections, including sepsis, following surgery occur at a rate of 5.23 percent, meaning that more than five percent of all surgical patients will develop an infection.
Patients who need help breathing may be placed on a ventilator. Ventilators have tubes that run down the throat and into the airway. The machine helps expand and retract the lungs and helps the patient breathe easier. Unfortunately, ventilators have been known to increase the risk of pneumonia. Ventilator tubes may provide an avenue for bacteria to travel into the lungs. Pneumonia, as a bacterial infection, is a common cause of sepsis in hospitals.
Strategies to Prevent HAIs and Sepsis in Hospitals
Due to some of the concerning rates of HAIs in U.S. hospitals, the CDC has initiated a series of prevention strategies. These strategies use surveillance, laboratory research, and outbreak investigations to develop improved prevention techniques. The CDC offers healthcare providers with toolkits and other information about how to prevent HAIs and protect providers and patients from infection. The CDC has specific guidelines for infection control and prevention, including:
- Disinfection and sterilization
- Hand hygiene
- Proper handling of laundry
- Environmental infection control
- Isolation precautions
- Multidrug-resistant organisms (MDRO)
- Catheter-associated urinary tract infections (CAUTI)
- Organ transplantation
- Surgical site infection (SSI)
- Dialysis infection control
- Disease/organism-specific infection control guidelines:
- Tuberculosis (TB)
The U.S. Department of Health and Human Services (HHS) has also developed a committee dedicated to the prevention of HAIs and sepsis in hospitals. The HHS Steering Committee for the Prevention of Healthcare-Associated Infections began in 2008 and continues offer support for prevention strategies and healthcare education. The Committee developed a National Action Plan to Prevent Healthcare-Associated Infections: Road Map to Elimination, which includes the following:
- Phase One: Focuses on the top six high priority HAIs:
- Surgical site infections
- Central line-associated bloodstream infections
- Ventilator-associated events
- Catheter-associated urinary tract infections
- Clostridium difficile (C. diff) infections
- Methicillin-resistant staphylococcus aureus (MRSA) infections
- Phase Two: Expands infection control efforts outside hospitals to outpatient settings including end-stage renal disease facilities and ambulatory surgical centers. Phase two also promotes better influenza vaccination rates among healthcare providers.
- Phase Three: Further expands efforts to include long-term care facilities like nursing homes, rehabilitation facilities, and skilled-nursing facilities.
- Phase Four: Reviews federal antibiotic stewardship efforts in various healthcare settings, and highlights the importance of stewardship in the prevention of HAIs.
Most healthcare facilities also have their own policies and procedures for infection control. It is up to those working in these environments, however, to follow policies and procedures that will prevent HAIs and sepsis.
Sepsis Specific Guidelines
Several organizations also have specific guidelines for preventing and treating sepsis in hospitals. Many of these guidelines are similar to that of HAIs, but they address more specific factors associated with sepsis in hospitals, including factors related to the environment, patient condition, and prevention policies.
CMS guidelines are titled “Severe Sepsis and Septic Shock Early Management Bundle”. These guidelines were established in 2015 with the goal of preventing sepsis, identifying infections earlier, and ensuring that treatment is initiated as soon as possible.
The Centers for Disease Control and Prevention (CDC) also has guidelines for managing sepsis in healthcare settings. The Surviving Sepsis Campaign is one of the most widely-accepted sets of guidelines. Created in collaboration between the Society of Critical Care Medicine and the European Society of Intensive Care Medicine, the guidelin