Catheter-associated urinary tract infection (uti)

The term hospital-acquired condition (HAC) refers to a medical condition acquired during a hospital stay that was not present on admission (Padula & Delarmente, 2019). Today the Center for Medicare & Medicaid Services (CMS) monitors about 14 different categories that fall under HAC. One of the 14 categories is hospital-acquired pressure injuries (HAPIs). Padula and Delarmente (2019) mentions that approximately 2.5 million Americans suffer from HAPI each year, despite the fact that most of these injuries are preventable. HAC can be detrimental to the patient’s life and can even leave the patient with unwanted conditions that were not there before. HAPI are associated with severe morbidity and mortality, as well as adverse effects on quality of life (Abela, 2021). In reality any one can be affected with a pressure injury, but the main population that it most affected are the elderly, who usually are underweight, cannot move adequately and have to stay in the hospital for long periods of time. It is estimated that there are as many as 60,000 deaths every year caused by pressure injuries (Padula & Delarmente, 2019).

             As shown, HAPI can bring about many problem to the patient and family member, even to the point of causing death. But the consequences of HAPI does not stop there. As a result, health care systems are faced with a substantial financial burden when it comes to HAPI care. According to previous estimates, the national cost for treating HAPIs is about $3.3 billion to $11 billion per year (Padula & Delarmente, 2019). But it not only affect the national cost, it has also started to affect hospitals. After CMS began to make cuts to the reimbursements for hospital-acquired conditions, which HAPIs is included, hospital have had to absorbed the cost and have seen the full financial burden of what it costs to treat a HAPI. A single HAPI episode can cost hospitals $500 to more than $70,000 (Padula & Delarmente, 2019). It is no wonder that CMS makes such a big deal about the prevention of HAC such as HAPI. As a result of CMS’s policy of reduced reimbursements for HAPIs, this tremendous potential financial burden should encouraging hospitals to improve their harm reduction strategies so that the development of HAPIs is prevented in the first place (Padula & Delarmente, 2019).

            It is therefore imperative that a primary goal of all hospital and residential health care organizations be to reduce avoidable HAPI. This will reduce morbidity and mortality, as well as improve patient safety. HAPIs represent quality of care indicators and are considered preventable in most cases. As a result of a reduction in HAPI, patient safety can be improved since the risk of injury from pressure damage can be reduced (Abela, 2021). When a hospital or healthcare facility is experiencing high rates of pressure injuries it could be an indicator that there is something wrong in the system, or policies need to be revised and changed. According to Delgado (2019) a few of the steps that are outlines in hospital policies when it come to the prevention of HAPI are; comprehensive assessments of the patients as soon as it is admitted, asses areas under pressure from medical equipment and bony prominences, promote mobility by repositioning patients frequently, the usage of barrier creams, pressure reducing mattresses and prophylactic dressings, get the wound specialist involved, and have them recommend specific interventions, document everything that is seen and done to the patient as it is getting done, let colleagues know about potential pressure injury that could develop, use tools provided to minimize the risk of pressure injury, get everyone involved in the intervention and prevention of new onset of  pressure injury, and last but not least, stay open to new research on approaches for the prevention of HAPI.

References

Abela, G. (2021). Root cause analysis to identify contributing factors for the development of hospital acquired pressure injuries. Journal of Tissue Viability, 30(3), 339–345. https://doi.org/10.1016/j.jtv.2021.04.004 (Links to an external site.)

Delgado, S. A. (2019). Strategies to avoid the unavoidable: Preventing Hospital-Acquired Pressure Injury. American Journal of Critical Care, 28(5), 353–353. https://doi.org/10.4037/ajcc2019590 (Links to an external site.)
  

Padula, W. V., & Delarmente, B. A. (2019). The national cost of hospital‐acquired pressure injuries in the United States. International Wound Journal, 16(3), 634–640. https://doi.org/10.1111/iwj.13071 (Links to an external site.)