HAI, also known as a nosocomial infection, persists as the infection acquired by the patient while in health facilities receiving various treatments and surgeries. Such infections frequently occur in various healthcare institutions such as long-term care facilities, surgical centers, rehabilitation centers, and hospitals (Siracusa et al., 2019). Notably, all healthcare facilities are susceptible to nosocomial infections, with some having greater risks, such as older adults, children inpatient with the compromised immune systems. Besides, factors including unhygienic conditions of healthcare providers, long-stay hospitals, overuse of antibiotics, and utilization of indwelling catheters increase the risk of contracting such infections. According to CDC (2019), HAI contributes to approximately 1.7 million infections in the United States and estimates 99,000 associated deaths annually. Furthermore, urinary tract infections exist as the leading HAI type, accounting for 32% in the United States (CDC, 2019). On the same note, 22% of the nosocomial infections are surgical site infections, and 15 % are related to lung disorders. Nevertheless, 14% of the HAI comprises bloodstream diseases. HAI contributed to high readmission rates after discharge from healthcare facilities (Siracusa et al., 2019). Patients spending more than 6 days in various healthcare facilities have five-time more of being readmitted after being discharged or have twice the chances of death due to nosocomial infection.
HAI exists as a significant problem in a healthcare setting, leading to multiple health and economic consequences. Many nosocomial infections in the United States annually accompany different expenses due to death and readmission costs in multiple healthcare facilities. HAI has increased hospital stay, attributable mortality, and the entire cost of healthcare to the American population (CDC, 2019). Nosocomial infection presents essential challenges to the healthcare sector, leading to diverse implications. For example, longer hospital stays have significant health implications for patients and families (CDC, 2019). Long stay in healthcare facilities contributes to physical, cognitive, and psychological deterioration, negatively affecting the patients’ health. Furthermore, overstays in hospitals due to HAI contribute to stress and depression among individuals, leading to their health. Bedridden patients grow weaker and less active, which impacts the medical outcome of the individual. Similarly, nosocomial infections lead to overstay in hospitals and readmission, which increases the costs in the health sector more so to the patient’s family (CDC, 2019). Overstaying in hospitals contributes due to HAI contributes extra treatment plans resulting in more costs. In some instances, HAI leads to deaths that affect the country’s family, healthcare industry, and economy.
Controlling microbial growth in the healthcare setting plays a significant role in preventing nosocomial infection, which reduces diverse costs in the healthcare industry. Moreover, limiting microbial growth depends on various factors, including the number of microorganisms, type, time of exposure, and environmental elements (Mubarak et al., 2019). Notably, sterilization exists as an excellent form of controlling microbial growth using dry-heat and moist-heat methods. Dry-heat sterilization in a hospital involves applying direct heat, such as that used in sterilizing the inoculation loop in the laboratory. The inoculation at high temperatures destroys the microorganism on the loop (Mubarak et al., 2019). Furthermore, hospital equipment can be sterilized through an oven which occurs as a dry-heat sterilizer, by outing the contaminated objects for two hours at 1700C. Moreover, moist-heat sterilizations effectively eliminate most microorganisms since the penetration of the bacterial cells by heat (Mubarak et al., 2019). Autoclaving exits as common means of moist-heat sterilization technique for the surgical equipment. The methods kill most vegetative cells, endospores, and viruses, making autoclaving an excellent way of controlling microbial growth, leading to nosocomial infection. Exposure of the microorganism to heats leads to denaturing their proteins and enzymes. Furthermore, employing different forms of sterilizations leads to coagulation of the microbial proteins, which inhibits their growth and death of the cells (Mubarak et al., 2019). Exposing the microorganism above the boiling point effectively kills the vegetative forms of diverse bacterial pathogens in healthcare settings, more so those found on surgical equipment. Furthermore, such moist heat successfully destroys viruses and fungi, including their spores, when autoclaved, depending on exposure time. For example, some types of viruses and endospores require longer exposure to heat for complete denaturalization (CDC, 2019). Notably, the hepatitis virus can survive 30 minutes above the boiling point and endospores up to 20 hours. Autoclave sterilization involves exposing the microorganisms to hot steam and pressure reaching a temperature of 1210C.
Various microorganisms are susceptible to sterilization by dry and moist heat. Most of the pathogenic microbes found in healthcare environments are susceptible to heats despite their spores requiring higher temperatures for an extended time. Autoclaving kills spores, fungi, viruses, and bacteria by denaturing their macromolecules, such as proteins. Sterilization assists in controlling different types of bacteria such as Staphylococcus aureus, Pseudomonas aeruginosa, Mycobacterium tuberculosis, Klebsiella species, and Escherichia coli. Furthermore, sterilization is essential in killing viruses such as Hepatitis and Influenza viruses.
Standard Operating Procedure for Autoclaving
Autoclaving has various parameters for effective sterilization outcome, including temperature, pressure, and time. According to CDC (2019), standard operating temperature ranges from 1210C to 1320C depending on the type of microorganism and equipment being sterilized. Furthermore, the length of the exposure varies depending on the volume and nature of the sterilized materials. As a result, the materials must direct contact with the objects being sterilized, leading to adjusting the temperature that can successfully eliminate the endospores for the complete process of sterilization. As per Mubarak et al. (2019), sterilization exists as an essential process in healthcare facilities; hence observing the standard operating procedure for quality control is fundamental. For example, the autoclave possesses recorders that facilitate documentation of temperature and pressure during the autoclaving process for efficiency and achieving the intended outcomes (CDC, 2019). Equally, autoclaving involves various internal indicators such as heat-sensitive autoclave tape having the white strips and turns black when the rights temperature is reached, indicating a successful autoclaving process. Furthermore, healthcare personnel should use the biological indicators using the liquid suspension containing endospores of the Geobacillus stearothermophilus for determining if all the endospores were killed during the autoclaving (CDC, 2019). The endospores of such microorganisms are utilized due to their nature of extreme heat resistance.
Prevention Practices and Benefits
Patients and hospital staff have a significant role in engaging in diverse practices that prevent the spread of microorganisms and increase nosocomial infections. For example, observing a high level of hygiene by the patients and care provider have significant benefits in the healthcare sector (Fernando et al., 2017). As per Fernando et al. (2017), Hygienic practices, including handwashing and isolation, contributes to limited chances of spreading the microbes from one place to another or from persons to persons. On the same note, washing hands ensures that microorganisms have little survival chances since most disinfectants used in handwashing kill pathogenic microbes (Fernando et al., 2017). Limiting chances of microbial contamination leads to reduced instances of readmission and related costs due to nosocomial infections. According to Fernando et al. (2017), taking precautions and practicing hygienic behaviors by patients and care providers benefits both families and the healthcare industry by reducing costs. Equally, medical staff and patients should observe regulations and protocols while in the hospital and interact with the overstayed patients. Observing the standard operations as stipulated by various healthcare agencies and institutions leads to limited carelessness and increase safety. For example, the movement and interaction of patients and care providers should have protocols and regulations to prevent unnecessary contact that could lead to infections due to the spread of the microbes (Fernando et al., 2017). Patients and healthcare professionals in hospitals should put on protective gear such as gloves and masks, limiting contacting microorganisms and spreading from the caregivers to the patients or patients to the clinicians (Fernando et al., 2017). Such practice plays a significant role in keeping patients and care providers safe from contracting nosocomial infections.
To conclude, HAIs exist as a significant issue in the healthcare sector, which requires the cooperation and effort of patients and medical staff to reduce the rates of occurrence. Nosocomial infections possess various economic and health impacts on families and governments. HAI leads to readmission and longer hospital stays, leading to extra cost on the families and expenditure by national and states governments. Notably, sterilization techniques such as autoclaving play an essential role in killing microorganisms in healthcare facilities. Moreover, the process requires observation of standard operating procedures to ensure efficiency through monitoring diverse parameters comprising time, temperature, and pressure. Besides, patients and caregivers have a key role through various practices to ensure the limited spread of the microorganisms from one person to another. Essential practices include observing hygiene through handwashing, following regulations and standards, and putting on protective gear.
References
CDC. (2019, April 16). HAI Data. Centers for Disease Control and Prevention. https://www.cdc.gov/hai/data/index.html
CDC. (2019, April 4). Steam sterilization. Centers for Disease Control and Prevention. https://www.cdc.gov/infectioncontrol/guidelines/disinfection/sterilization/steam
CDC. (2019, September 5). CDC winnable battles progress report. Centers for Disease Control and Prevention. https://www.cdc.gov/winnablebattles/report/HAIs.html
Fernando, S. A., Gray, T. J., & Gottlieb, T. (2017). Undefined. Internal Medicine Journal, 47(12), 1341-1351. https://doi.org/10.1111/imj.13642
Mubarak, M. T., Ozsahin, I., & Ozsahin, D. U. (2019). undefined. 2019 Advances in Science and Engineering Technology International Conferences (ASET). https://doi.org/10.1109/icaset.2019.8714223
Siracusa, M., Scuri, S., Grappasonni, I., & Petrelli, F. (2019). Healthcare acquired infections: malpractice and litigation issues. https://doi.org/10.7416/ai.2019.2310
