Introduction
The authors aimed to assess whether the rate of hospital-acquired infections (HAIs) would dramatically reduce with the advent of COVID-19 measures in hospitals. The breakout of COVID-19 in 2020 indicated that hospitals had to increase their prevention and control measures to eliminate hospitalized individuals from contracting COVID. The heightened measures taken by the hospital were analyzed to assess if they translated to a rapid decrease in hospital-acquired infections. A demonstration of proof of a reduction in HAIs due to increased preventative measures, then the study would have implications for hospital administration.
It would serve as a call to action for hospital administrators to increase their preventative measures to prevent hospital-acquired infections. HAIs are common in modern hospitals and remain a critical challenge that hospitals strive to reduce. The risk for HAIs is 5-10% for all patients and could increase to 30% for those under intensive care. Invasive procedures such as catheters further enhance the risk (Tham et al. 1249). Reducing HAIs results in cost cuts and a better quality of stay for individuals admitted to the hospital. COVID-19 prevention measures called for increased hand hygiene. Hands are vital vectors for micro-organisms and are responsible for HAIs. The researchers aimed to determine whether a correlation existed between improved hand hygiene and reduced HAIs in normal wards and intensive care units.
Procedures
The researchers adopted a retrospective cohort study at the Royal Melbourne Hospital in Australia. The exposure group for the duration comprised a cohort of individuals undergoing surgical interventions between 1st April 2020 and 30th June 2020. The comparative group comprised those admitted between 1st April 2018 and 30th June 2019. The total number of individuals admitted during the two periods was 5945 admissions. The data was collected from various administration points, including patient administration system data and Australian Procedural Codes on Classification of Healthcare Interventions.
The exposure variables were based on the changes made in 2020 to IPC measures and the rapid increase in hand hygiene. The changes that occurred during the period were substantiated via several methods, including the National Hand Hygiene Initiative (NHHI) data. The NHHI audit consolidated measurements on compliance to hand washing by performing intermitted sampling on nurses in various hospitals and healthcare centers based on the WHO five moments model on hand hygiene. Co-variables measured by patients include other comorbidities, physical status, and demographics. HAI outcome was determined by considering the ICD-10-AM codes.
Statistical Tests
The statistical method used to determine the presence of HAI for the exposure period of interest in the study is univariable logistic regression. It was also implemented to be used for all the other co-variables. The co-variables in which the statistical method was implemented are inclusive of the changes made in 2020 figures and hand hygiene implementation in the duration. The principal exposure of interest and other co-variables that affected odds greater than 10% were subjected to multivariate logistic regression analysis.
Results and Conclusion
The study demonstrated that the hand hygiene measure implemented during COVID-19 had no marked effect on the odds of acquiring an HAI despite being adjusted for other variables like patient comorbidities, physical condition, and demographics.
The findings for 2019 indicated that 6.6% of admitted patients acquired HAIs relative to 7.1% in 2020. The findings further indicated no noticeable change like micro-organisms involved in transmitting HAIs relative to the two time periods. The researchers noted that other studies indicated the positive effects of increased hand hygiene measures on HAI acquisition. However, these studies were limited to specific cohorts of patients in particular wings, such as cardiothoracic and neurosurgery wards. The current study is also limited as it only considers patients of surgical interventions. Overall, the implication is that there is a plateau effect with the measures with a pre-existing high baseline of practices.
Work Cited
Tham, Nicole, et al. “Hospital Acquired Infections in Surgical Patients: Impact of COVID-19-Related Infection Prevention Measures.” World journal of surgery 46.6, 2022, pp. 1249-1258.