People who are sick certainly don’t deserve to get sicker, and yet this is just what occurs with a nosocomial infection. These infections are also termed health care or hospital acquired illnesses, and in places like the US, they occur in about 10% of patients. This typically includes any long-term care facilities or rehabilitative facilities.
Patients may pick up infections in the hospital because bodies are in a weakened state due to disease or its treatment, and many people have surgical wounds or tubes that increase the chance of infection occurring. The main nosocomial infection types that may occur include, in order of frequency, urinary tract infection, infections at an entry area of surgery, various forms of pneumonia, and infections that affect the blood (sepsis).
Most nosocomial infections are spread by contact between certain germs and the patient, either by a visitor or caretaker, or by coming in contact with hospital equipment. These are called direct contact and indirect contact transmission. Many times direct contact occurs when a health care worker cares for a patient without properly washing hands, but indirect contact may be just as likely, and can include transmission of illness if people don’t use equipment properly or according to instructions.
Direct contact isn’t always the fault of health care workers. Patients can contaminate each other through touch, and visitors to the hospital who are unwell or have touched any surfaces in the hospital on the way a patient’s room may cause a nosocomial infection if they don’t wash their hands. Alternately, they can communicate a present illness through sneezing or coughing.
This last example is called airborne transmission. Another way that airborne transmission might occur is if certain bacteria or germs are recirculated through the air in patient’s rooms. To avoid this hospitals often place people with conditions like legionella and tuberculosis in areas where chance of infecting other patients is minimal.
Nosocomial infections can be costly. In rare instances they may cause life-threatening illness or death. In most circumstances what they do is cost time, money and additional discomfort to the patient. People with a nosocomial infection are likely to need to stay in the hospital longer, and this means additional expense for government health reimbursement agencies and for health insurance companies.
There are many government agencies, like the US Centers for Disease Control, which work to investigate how to prevent or reduce nosocomial infections, and it’s even been proposed by some politicians than any government funded agency refuse to pay for these infections since they are often caused by inattention to hygiene practices. However, concern would exist that cost would simply be shifted onto the patient, who is clearly not at fault, or that hospitals would raise prices for all patients to make up financial losses.
Perhaps these infections can’t be fully prevented, but there are certain things people can do to reduce risk. Shorter hospital stays when possible are typically preferred because each day risks infection. People should feel free to ask nurses, doctors or other healthcare workers to wash their hands if they don’t do so when entering a room. Those staying in hospital should ask friends not to visit if they’re not well, as an extra preventive, and should also feel free in voicing concerns if a hospital roommate seems to have active signs of viral infection or if this noted in the hospital roommate’s visitors.
These requests can make a patient seem difficult, which is why perhaps the best thing to bring to the hospital is a family member or friend who can advocate and make these requests on the patient’s behalf. The risks of nosocomial infection are pretty clear, and as yet, hospitals have not found a way to fully avoid them. If a patient’s advocate reduces this risk at all, it is certainly worthwhile.
