According to a Centers for Disease Control survey published in 1992, more than two million people annually pick up infections in the hospital, with approximately ninety thousand deaths caused by these infections. Hospital-acquired contagions account for about one half of all hospital complications. Therefore, we are dealing with a problem on a massive scale.
There are two basic pieces to learning the cause and control of this dilemma: (1) It is the nature of the beast - infected people go to hospitals because that is where they need to be. (2) Human behavior plays the largest role in the spread of infectious organisms.
To begin with, from a public health perspective, every hospital is a micro-bug magnet. Sick people go to hospitals, and that includes everyone who has a contagious disease. So a hospital is where you will find a concentration of people with tuberculosis, hepatitis, anthrax, influenza, AIDS, herpes, syphilis, gonorrhea, pneumonia, viral meningitis, and every other conceivable infection. The goal of the nurse-epidemiologist is to prevent the spread of communicable diseases within the hospital.
Regarding human behavior, there are at least eleven ways in which hospital personnel contribute to the incidence of infection:
- failure to wash hands between patients
- failure to change gloves between patients
- failure to provide ventilator maintenance
- failure to provide catheter care
- contamination in the operating room during surgery
- breach of sterile technique during dressing changes
- breach of sterile technique during insertion and maintenance of vein catheters
- failure to properly dispose of biohazard waste
- failure to isolate patients with infectious diseases
- breach of isolation technique
- failure to provide appropriate treatment for infection