With World Cancer Day this Saturday, we dedicate this post to those patients facing a cancer diagnosis. As with any serious disease, the many types of cancer put a great deal of stress on the body and can make a person more susceptible to infection. Unique to cancer, however, are the infection risks due to the disease's treatment. Today we will explore how cancer and infection intersect in this special population.
Medical researchers have recently placed more emphasis on the non-medical conditions that impact patient health and outcomes. Collectively known as social determinants of health (SDOH), these are the conditions surrounding birth, growth, living, working, and aging. The distribution of money, power, and resources play heavily into the formula: Those lacking stable access to any (or all) of these factors see impacts on health, including exposure to and infection by disease-causing pathogens. In today's post, we'll explore the intersection of SDOH and infection control and prevention, and describe some of the ways today's health system is trying to address this issue.
This series on outpatient services and infection control can seem rather dismal. Thankfully, most outpatient facilities are safe and only a small percentage of patients experience an HAI. Nonetheless, the breaches in infection control mean that given the right circumstances, severe outbreaks can (and do) take place. The reality can make us feel powerless and confused. Fortunately, there are things that we can do to help.
So far in our series on infection control in ambulatory care settings, we covered the types of facilities and how they are regulated. One huge topic to cover is the impact of the outpatient setting on the ability to track infections. Today’s post will begin to explore this topic, and our final post will present what we can do, both individually and collectively, to begin to improve infection prevention in these facilities.
No one wants to stay in a hospital any longer than they have to. We all have an innate desire to get back to the comfort of our homes and begin the process of returning to normal activities. Some of us may not realize that there is also a very real, scientific reason for leaving the hospital as soon as possible: The longer a patient is in the hospital, the greater their chances of getting a hospital-associated infection (HAI), and once a patient has an HAI, they tend to stay longer in the hospital. It seems like a lose-lose scenario for everyone involved. It's just in everybody's best interest to reduce HAIs to not increase LOS, and shorten LOS to reduce HAIs. In today's post, we'll see how healthcare facilities are working to accomplish this dual goal.
We don’t know enough about infection in ambulatory care centers.
Any kind of medical treatment received outside of a hospital admission is considered ambulatory care, or outpatient care. This category of healthcare is growing very quickly; in fact, it is the fastest growing health care market in the US! Outpatient services are growing in popularity for two main reasons. First, they are less expensive than hospitals, which have much higher overhead costs. The second reason is that medical improvements have made outpatient services far more practical. The quality of home health care through technology and nursing services allow patients who would have had to be in a hospital receive the necessary care at home.
Up to 75% of surgical procedures in the US take place in the more than 5,000 outpatient surgical centers. (There was a 300% increase between 1996 and 2006, the last time a survey was made. More on that in our next post.) Add to this the number of scans, tests, dialysis sessions, chemotherapy treatments, and other procedures and you begin to see the vast numbers of individuals receiving medical care at ambulatory care facilities. As more and more of us choose these outpatient services for increasingly complex procedures, it is all the more important to learn about this critical area of health care.
In late January of 2016, the CDC issued a health advisory “urging dialysis providers and facilities to assess and improve infection control practices to stop Hepatitis C virus transmission in patients undergoing hemodialysis.” This advisory was released after an increase in Hepatitis C infections, and the preliminary evidence that transmission from patient to patient had taken place in at least 9 clinics. This advisory brought to mind the issue of infection in other outpatient settings and inspired the topic of this series, “Outpatient Services and Infection Prevention.”
Think back to the last time you or a loved one was a patient in a hospital or healthcare facility. What things do you remember most? Is it the stress about health and recovery? Maybe you remember the frustration of trying to get answers or understanding what was going on? Or perhaps you remember a constant worry about whether the hospital was clean enough to prevent an infection? If any or all of these are familiar, you are not alone. A recent study investigated what patients consider the most important aspects of a quality hospital, and as this post will reveal, how infection prevention is their top concern.
The word “reputation” comes from words meaning “to judge repeatedly.” This idea of forming an opinion, and reforming it over and over again as time goes on, is the critical aspect of reputation: It is not something that is set in stone, but rather, is reconsidered and reevaluated indefinitely. This is especially true with a hospital’s reputation, which can move positively or negatively in the span of months, reflecting the impact of news coverage, public ratings, or financial status. So what is the role of infection prevention and control in helping form - and maintain - a hospital’s good reputation?