If you need to go to hospital, the last thing you want is to come out sicker than when you went in. The ultimate paradox of health care: going to the hospital can kill you and the reality of healthcare today is that hospital-acquired infections (HAIs) which patients can contract while receiving medical treatment in a healthcare facility, are a major, yet often preventable, threat to patient safety and wellbeing.
HAIs increase patient fatality rates, the risk of acquiring other infections, and length of stay in hospital, thus also increasing health care costs. HAIs may be caused by viruses, bacteria or fungi, and most commonly affect the urinary tract, respiratory tract, wounds and blood.
In developed countries, between five to ten percent of patients admitted to acute care hospitals acquire an infection which was not present or incubating on admission. The rate for developing countries can exceed 25% and while there are no concrete statistics for South Africa, we probably fall somewhere in between these numbers.
Organisms which under normal circumstances simply cause disease, can be life-threatening to ill or post-surgery patients who are exposed to them and manifest themselves as HAIs, often picked up in intensive care units and contracted in hospital environments, and this is worsened by steadily-rising incidences of antibiotic resistance.
According to Fasie Smith, national clinical and business strategy manager at Advanced Health, there is a lower risk of contracting HAIs among patients who attend day hospitals for outpatient surgeries. “Preventative and control measures such as improved sanitation, clean air flow, sustainable antibiotic use and antimicrobial stewardship help to manage HAIs in hospitals. However, the best way for the healthcare industry to restrain the spread of these infections is to minimise the time that patients are exposed to them, reducing the chances of ill people contracting HAIs in the first place. One way to achieve this is to simply cut down the number of hours in which patients are in hospital environments, the hot spots in which HAIs thrive,” Smith says.
Day hospitals as the name suggests, are used solely for surgical procedures that do not require overnight hospital stays. Facilities in the Advanced Health group, for example, will only admit low-risk patients who require safe surgical procedures typically associated with fast recovery times. Patients then return home on the same day, once the doctor has checked and discharged them. Thanks to the operating model of day hospitals, facilities don’t need to have ICUs, nor do they cater for overnight stays, which naturally means less exposure to HAIs for outpatients.
“Aside from the compromised individuals and their families who are affected by these infections, they’re also impacting on healthcare costs in South Africa. As antimicrobial resistance grows, the severity of disease continues, and the size of the ageing population continues to grow, the burden is set to increase, and so preventative measures are becoming increasingly important from a national healthcare perspective,” says Smith.
Another way to avoid the spread of HAIs is for individuals to limit antibiotic use. While these drugs are effectively and commonly used in modern healthcare for the treatment or prevention of serious infections in surgical patients or protecting people with compromised immune systems, they are also unnecessarily and overused by some doctors.
It’s a common issue in South Africa that GPs prescribe antibiotics to patients who have flus or colds, which are viral infections and in reality, not even cured by antibiotics. This overuse of the drug drives up antimicrobial resistance in people, perpetuating the problem.
Antibiotics are also used to promote growth and prevent disease in some livestock and other food animals, which when consumed by humans, further increases their resistance to these drugs.
Smith believes that South Africans should take responsibility for their health and wellness, and that of their children and loved-ones when it comes to the exposure of and resistance to antibiotics.
“If a doctor prescribes antibiotics for a viral-based illness like flu or the common cold, push back and ask for an alternative treatment. Be cognitive about the food you eat and opt for organic meat that is antibiotic-free. And finally, if you or a loved-one requires a low-risk surgical procedure that can be performed in a day hospital, insist upon using one as it will further reduce exposure to these dreaded infections,” Smith concludes.