Running Head: HOSPITAL-ACQUIRED INFECTIONS (HAIS) 1

Research Proposal Draft

Hospital-Acquired Infections (HAIs)

By: Luiza Azimova

HSC 484 Adv. Research & Writing in HSC Section 502

Jacquelyn Arendt

Date: 11/17/2019
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Abstract

The study demonstrate the relationship between Hospitals acquired infection and patient care.

The exploratory study describes the HAIs may lead to patient severe consequences who enter in

hospital for disease treatment. The study aim describes to investigate the impact of Hospital-

Acquired Infections (HAIs) on hospital care. Hospital-acquired infections (HAIs) associated with

increase healthcare cost, length of hospital stay, and attributable mortality and these impact

shows negative impact on patient care. The study consolidates deductive approach of research

methodology and utilize survey to construct and find out research answer. The hypothesized

relationship has been built by considering existing theoretical literature review. At last, research

analysis and significance develop strong arguments that HAIs have negative impact on patient

care.

Keywords: Infections, morbidity, hospitals, and health problem.

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Introduction

Hospital-acquired infections (HAIs) considered the most important aspect in healthcare sciences

where a number of researches had been taken place but missed its relationship with hospital care

impact. The study investigates the impact of HAIs on hospital care where role of physicians and

other professionals will discuss while doing treatments and following preventive measurement.

This topic is neglected in various healthcare facilities which could be major threat for U.S

healthcare industry because HAIs develops number of other diseases [ CITATION Tay16 \l 1033 ].

Hospital-acquired infections (HAIs) are increasingly problematic issues in U.S hospitals which

results in increased patient morbidity [ CITATION Boe16 \l 1033 ]. Dealing with HAIs is a key

factor to reduce complex disease rates. HAIs can be spread by diverse routes such as surgery,

intravenous routes, water, and air environment of hospital. Multiple studies have been indicated

common types of HAIs and their adverse impact on hospitalized patients. HAIs consider top

leading causes of death in USA because out of every 100 hospitalized patient the 10 patients

involved HAIs [ CITATION Meh14 \l 1033 ].

Research question

What is the impact of hospital-acquired infection on hospital care?

Hypothesis

H1: There is a relationship between hospital-acquired infections with hospital care.

H0: There is not any relationship between hospital-acquired infections with hospital care.

Specific aims

Investigate the impact of Hospital-Acquired Infections (HAIs) on hospital care

HOSPITAL-ACQUIRED INFECTIONS (HAIS) 4

Examine the sources of HAIs and develop strategies to counter issue

Background and significance

Hospital-Acquired Infections (HAIs) is the major issues on hospital care facility.

According to centers for disease control and prevention, about 1 in 25 U.S hospital patients

diagnosed with hospital infection. HAIs caused serious antibiotic-resistant bacteria that may lead

to death. In 2009, the federal government had established national action plan to prevent

healthcare-associated infection. The state established programs warrants hospitals to execute

strategies to manage HAIs [ CITATION Fer17 \l 1033 ].

Hospital-acquired infections (HAIs) associated with increase healthcare cost, length of

hospital stay, and attributable mortality. The infections acquired in hospital that first appear

within 48 hours after admission in the hospital or within 30 days after discharge of patient. The

hospital infection is unrelated to original illness which brings patient to the hospital. There are

various reason that these infections are more than alarming in current century of healthcare

system. Because higher the rate of hospital-acquired infection may increase number of patient,

increased outpatient treatment, inadequate sanitation protocol, moving of medical staff from

patient-to-patient which may generate pathogens, and preventive measures may be unheeded by

healthcare professionals [ CITATION Meh14 \l 1033 ].

The HAIs can be occurred in both pediatric and adult patients. The bloodstream

infections followed by urinary tract and pneumonia infections and these are most common

infections in children [ CITATION Fer17 \l 1033 ]. Among pediatric patients, the babies with low

birth weight of less than 1000g have higher rates of healthcare associated infections. Thus, the

impact of HAIs has increased patient length of stay as well as healthcare cost. For this reason,
HOSPITAL-ACQUIRED INFECTIONS (HAIS) 5

there is a strong relationship between patients and HAIs. It should be known that patient care

entitled with healthcare professional responsibilities to make sure quality care delivered and took

precautionary measurements [ CITATION Ang12 \l 1033 ].

According to national and state healthcare-associated infections report, it has been

identified that 8-12% decreased in CLASBI, Onset C. difficile infection, and CAUTI during

2017 and 2018 but there are no significant changes in Onset MRSA bacteremia, SSI, and VAE

[ CITATION Cdc194 \l 1033 ]. It indicates that awareness with preventive measurements is the need

of current healthcare system to manage HAIs effectively. The anticipated research outcomes are

to reduce HAIs rates and develop consistent strategies for hospitals to future occurrences of

healthcare infections [ CITATION Boe16 \l 1033 ].

The most common method of containment is infection either through hospital staff or

visitors and medical instruments. The surgeons’ disinfection procedure may include negative

side effects of mechanical irritation, hand scrubbing many times a day, allergic stress for skin,

and other chemical effects of using instrument [ CITATION Boe16 \l 1033 ]. These are the

procedures of healthcare professional to patient treatment which increase their length of stay due

to hospital infections. The symptoms of infections contains general malaise, skin rash,

tachypnea, tachycardia, and fever.

The patient with pneumonia may have purulent sputum, cough, fever, and abnormal chest

auscultator which decrease wheezes, crackles, and breathe sounds. In addition, the patient with

urinary tract infection can have suprapubic tenderness with pyelonephritis. The epidemiology of

HAIs severely impact patient health which may lead to death [ CITATION Car18 \l 1033 ]. The HAIs

can be caused by fungal, bacterial, and pathogens which are born with healthcare facility. Such

kind of pathogens should be examined in every febrile patients that are admitted for no febrile
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illness. It has been identified that most of the patient who have HAIs in caused by fungal

pathogens which is called predisposition to infections.

There are certain risk factors associated with catheter associated bloodstream infections

especially in the neonates which contains catheter hub colonization, catheter insertion, and exist

site colonization. The risk factors of urinary tract infection to pediatric patients include cerebral

palsy, prior antibiotic therapy, and bladder cauterization. These risk occurred in hospital without

having proper awareness to both patient and physician [ CITATION Naz14 \l 1033 ].

The European prevalence infection of intensive care has been identified various factors of

predisposition of a patient to hospital acquired infection. About 40% of infections are occurred

due to poor hand hygiene which is transmitted in hospitals. Various surveys have been indicated

that there is a need of improvement in compliance regarding washing hands to reduce the impact

of hospital acquired infections. A national surveillance of HAIs need to be improved to develop

advanced system for the surveillance of hospital acquired infections that occurred within or

outside the hospital premises [ CITATION Mai18 \l 1033 ].

Now the question is how HAIs occurred to determine the impacts on patient care. The

infections can be transmitted from patient-to-patient through medical staff. The common objects

in hospital are cross contaminates patients and stethoscopes. In addition, the inadequate staff

training also led to development hospital infections that ultimately results in increased wait

times. Thus, hospital and healthcare clinics are mandatory required to follow policies and

protocols to prevent HAIs [ CITATION Mai18 \l 1033 ].

Regardless of the type or cause if infection, there are several impacts investigated. First

and foremost impact of HAIs death. According to the alliance for aging research, it has been
HOSPITAL-ACQUIRED INFECTIONS (HAIS) 7

examined that about 99,000 people have been died yearly due to hospital acquired infections. In

addition, HAIs lengthen the recovery time as well as prevent patient from returning to work and

they lost wages. Moreover, the other impact is increased cost due to HAIs, because long hospital

stays means more cost will required for the treatment and patient will bear more care of cost

[ CITATION Has17 \l 1033 ].

Basically, the research determines the impact on patient care who enter in hospital for

treatment and discharge with hospital infection due to bacterial contamination. The study finds

causes and types of HAIs which can be minimized and prevent them from infections. Therefore,

it is a responsibility of hospital to strengthen measurements during patient treatments [ CITATION

Meh14 \l 1033 ].

Sources Transmission Organism

Microbial flora Direct contact through Vancomycin-resistant

devices and staff hands enterococci

Inanimate hospital Staff hands Methicillin-resistant

environment staphylococcus aureus

Hospital equipment Disinfection with endoscope Hepatitis C virus and

Mycobacterium
Infected patient Respiratory droplet Influenza virus
Staff member or infected Blood borne Hepatitis C& B, and HIV

patient
Figure 1: Sources and transmission of hospital-acquired organisms

The causative organism usually originate from patient’s own microbial flora that can be altered

with hospital organism. Such causative organism cover spectrum as well as individual species

between hospitals and units. The prevention of antibiotic resistance can help to manage hospital
HOSPITAL-ACQUIRED INFECTIONS (HAIS) 8

acquired infections. Secondly, prevention of organism spread can give desirable results to restrict

the origination of hospital-acquired infections [ CITATION Nek17 \l 1033 ].

Methods

Research design

The current research design associated with both qualitative and qualitative approaches to

explore the results in an effective manner. For qualitative data analysis, the secondary resources

will be utilized where data will be collected from peer-reviewed journal articles. In this regard,

the deductive approach will be used where HAIs investigated in various hospitals of Cleveland

state. The hypothesized relationship would be built by considering existing theoretical literature

review. After developing hypothesized relationship, it will be evaluated through deductive

approach. The selected research design aligns with research question.

Time-Line

Research activities September February August Decembe February

2019 to 2020 to 2020 to r 2020 to 2021 to

February July 2020 November January August

2020 2020 2021 2021

Brainstorming of research

idea
Introduction and background
Literature review
Research methodology
Data analysis
Research generalizability
Conclusion
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The above-mentioned table indicates that research will be completed within 2 years beginning

from brainstorming ideas to conclusions.

Subject/Participants

A simple random sampling methodology will be used where some positions will be

entitled to interview. The research participants will be patients from various departments.

Emergency, cardiology, surgery, Oncology, Neurology, intensive care unit, and maternity wards

will be targeted participants of current research. The hospitals would be Cleveland Clinic –

Lutheran Hospital, University Hospitals Cleveland Medical Center, University Hospitals

Rainbow Babies & Children Hospital, and Cleveland Clinic - Fairview Hospital. At last, the

sample size would be 50 professional doctors.

Materials

Basically, the research associated with conducting structured interviews where questionnaires

would be the best instrument to collected data from targeted audience. The copy of questionnaire

will be attached in the draft of the proposal.

Procedures

The hospital-acquired infections HAIs are independent variable and hospital care facility is the

dependent variable. Towards hospital care facility various will be measured to determine the

impact of HAIs on healthcare facilities. For instance, cost, patient living in hospital,

precautionary measurements, safety, and standard operating procedures. For data collection, the

volunteers would be hired to collect the data which means personnel will be recruited.

Data analysis plan

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The research statistics will be used to pave the research methodology and results of study

participants will be explored to reach desired study objectives. For data interpretation,

descriptive as well as explorative analysis will be used. The other alternative interpretations such

as statistical values will be presented to strengthen study outcomes.

Conclusion

Hospital-acquired infections consider one of the leading causes of preventable illness in the U.S

healthcare industry. Many of the bacteria and pathogens contribute to developing HAIs and this

issue is prevalent all over USA. The existing research studies had made remarkable preventive

studies but unable to find out the relationship of HAIs' impact on hospital facility while

considering preventive measurements. The aim of study is to answer what outbreaks and

interventions can be implemented to reduce HAIs rates.

The future research will dominate policies and standards within the hospital facility to get rid of

infections. The future research will develop standard operating procedures related to cleanliness

and physician training to manage safety prospects during treatment. The current plan will

recommend these research outcomes so that controlled intervention can be taken place in an

effective manner.
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References

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https://www.cdc.gov/hai/data/portal/index.html

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