Globally, healthcare-associated infections, are threatening the lives of many by increasing the morbidity and mortality rates. According to Arefian et al. (2019), HAIs are associated with an individual’s prolonged length of stay in the hospitals, which also increases the treatment costs. For example, the WHO reported an extra cost of 13-24euros per year and 50,000 deaths resulting from HAIs in various European hospitals (Arefian et al., 2019).
Significance of the problem
HAIs are life-threatening, whose problem is further exacerbated by the associated pathogens increasing resistance to drugs. Caselli et al. (2018) assert that hospital surfaces persistent contaminations are the key players in HAIs transmissions especially because they neither prevent recontamination nor effectively controlled by the conventional type of cleaning thus, highly favorable to some form of microbial strains that can be drug-resistant. The purpose of the paper is to assess the effectiveness of the probiotic type of cleaning in minimizing the cases of HAIs. The PICOS questions governing the research include: Do Probiotic cleaning systems abate stably the pathogens on hospital surfaces? Is the probiotic approach effective in eradicating the antibiotic-resistant microbial species?
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Purpose of the paper
The foreground question governing this research is preventive. This is because the essay aims to assess the effectiveness of the Probiotic type of cleaning in the eradication of HAIs in the hospital surfaces. This research will gather information from prospective cohort studies in hospitals, which have implemented the Probiotic type of cleaning and those without to ascertain whether the approach is effective in minimizing the cases of HAI.
Evidence Matrix
| Article | Reference | Purpose Hypothesis Study Question | Variables Independent Dependent | Study Design | Sample size and Selection | Data Collection Methods | Major Findings |
| 1 | Arefian, H., Hagel, S., Fischer, D., Scherag, A., Brunkhorst, F. M., Maschmann, J., & Hartmann, M. (2019). Estimating extra length of stay due to healthcare-associated infections before and after implementation of a hospital-wide infection control program. PloS one , 14 (5). | Does the effectiveness of a prevention program in the whole hospital affect the additional length of stay from HAIs? | I-Prevention program D-Length of stay | Quantitative | N-26,943 patient in the first trial, N-35,211 in the second trial Non-randomized trials in Jena University Hospital in Germany | Prospective cohort analysis | The HAIs infection prevention programs do not reduce the increased length of stay because of HAI. However, they change the length of stay in various health care units such as ICU in some cases which reduce costs |
| 2 | Caselli, E., Brusaferro, S., Coccagna, M., Arnoldo, L., Berloco, F., Antonioli, P., ... & Conte, A. (2018). Reducing healthcare-associated infections incidence by a probiotic-based sanitation system: A multicentre, prospective, intervention study. PLoS One , 13 (7). | Can the probiotic cleaning hygiene system (PCHS) affect the HAIs case? | I-Probiotic system D-Healthcare Associated Infections | Quantitative | N-6 public hospitals in Italy Randomly picked while the control hospital was selected | Prospective cohort analysis | A stable reduction in HAIs case was visible after the PCHS sanitation introduction |
| 3 | Voidazan, S., Albu, S., Toth, R., Grigorescu, B., Rachita, A., & Moldovan, I. (2020). Healthcare-Associated Infections—A New Pathology in Medical Practice?. International Journal of Environmental Research and Public Health, 17(3), 760 | What HAI, are identified in Mures County public hospitals? | I-Clinical departments in public hospitals in Mures County D- Health Associated Infections | Quantitative | N-7 public hospitals in Mures County in Romania | Cross-sectional Study design | Data confirms a clear correspondence between the health departments and the various forms of infections, and their effects on mortality. |
Description
Arefian et al. (2019) investigate the effects of a hospital-wide program such as the washing of hands and implementation of prevention bundles in reducing HAIs additional stay in the hospitals. The article gathers information from non-randomized trials in Jena University Hospital in Germany, involving 26,943 patients in the first surveillance, and 35,211 in the second trial, after the implementation of the infection prevention strategies (Arefian et al., 2019). Estimation of the additional length of stay using the multistate technique shows that various factors are in play including the type of infections and the inpatient's units. This study is limited on several aspects including the conduction of the economic analysis since the infection control strategies were unable to reduce the HAIs rates (Arefian et al., 2019). The study is also prone to Hawthorne bias, which results from being watched thus, resulting in wrong results, while some units do not comply with hand hygiene because of lack of time, high activity levels, and large workloads. This article answers my question in the sense that hospitals employing other interventions programs other than the probiotic type of cleaning have high rates of HAIs compared to those using the PCHS approach.
Caselli et al. (2018) research is directed at ascertaining whether PCHS is effective in eradicating the surface pathogens without leaving the antibiotic-resistant microbial. The study is in 6 public hospitals in Italy where pre-post interventional research was carried out in Internal medicine wards for 18months. The analysis involved the substitution of other conventional types of cleaning with the PCHS while other factors influencing HAI’s spread remained unaltered (Caselli et al., 2018). The results show that PCHS resulted in a reduction of 4.8% to 2.3% HAI cumulative incidence and also reduced the surface pathogens. The findings confirm that PCHS is effective in reducing the HAIs incidences during hospitalization thus answering my question.
The Voidazan et al. (2020) article analyses the HAIs cases identified in public hospitals in Mures County by evaluating the reported cases that follow the Romanian legislation. The cross-sectional study design helped in the tracking of the reports of the hospital-acquired infections in 2017-2018, which showed 1024 cases were discharged during the study period. The intensive care units had the most frequent HAIs cases with common infections being urinary tract infections, bronchopneumonia, sepsis, Enterocollis, and surgical wound infections. The research gave a clear correspondence between the type of HAI and the medical units, which led to the recommendation of vigilant, rapid control and prevention approaches of HAI (Voidazan et al., 2020). This research did not answer the current research question thus; it needs to implement the PCHS prevention strategies in the various medical units to assess the impact of the strategy in minimizing the cases of HAIs.
Therefore, the three research findings confirm that various intervention strategies have some influence on the HAIs incidences. However, more information is required to ascertain the effectiveness of PCHS in various hospitals in the world. Questions to govern the group's work include; How effective is the PCHS in reducing HAIs associated with the intensive care unit? Can PCHS interventions affect the length of stay of individuals in the various healthcare units?
Conclusion
Estimation of the additional length of stay using the multistate technique shows that various factors are in play including the type of infections and the inpatients' units (Arefian et al., 2019). Arefian et al. (2019) confirm that HAIs prolong the length of stay of patients in hospitals thus, increases the hazard mortality rate as well as the cost of care. The information provided from the article can help policymakers in health to adopt the most effective prevention measures to invest in to save healthcare costs and improve patient's health. The Caselli et al. (2018) research shows that PCHS led to a significant reduction of 4.8% to 2.3% HAI cumulative incidence. More so, the PCHS resulted in a stable reduction of surface pathogens when compared with the conventional methods of cleaning. Moreover, it is responsible for a 2 log drop of drug-resistance surface microbiota. Caselli et al. (2018) lead to the understanding of the environmental microbiota's role in hospital settings thus informs on developmental guidelines on cleaning environments to enhance infection control and prevention approaches.
The Mures county public hospital's routine analysis shows that there is a relationship between the health units and the various infections (Voidazan et al., 2020). The research confirms that the healthcare-related infections are a reality in the whole world thus emphasizes on the role of every medical unit together with the patients in minimizing the cases of HAI to increase the life expectancy of the patients.
References
Arefian, H., Hagel, S., Fischer, D., Scherag, A., Brunkhorst, F. M., Maschmann, J., & Hartmann, M. (2019). Estimating extra length of stay due to healthcare-associated infections before and after implementation of a hospital-wide infection control program. PloS one , 14 (5). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6524816/
Caselli, E., Brusaferro, S., Coccagna, M., Arnoldo, L., Berloco, F., Antonioli, P., ... & Conte, A. (2018). Reducing healthcare-associated infections incidence by a probiotic-based sanitation system: A multicentre, prospective, intervention study. PLoS One , 13 (7). https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199616
Voidazan, S., Albu, S., Toth, R., Grigorescu, B., Rachita, A., & Moldovan, I. (2020). Healthcare-Associated Infections—A New Pathology in Medical Practice?. International Journal of Environmental Research and Public Health, 17(3), 760. file:///C:/Users/LENOVO/Downloads/ijerph-17-00760-v2%20(1).pdf
