What are hospital infection outbreaks?

The definition of a healthcare-acquired-infection (HAI) is clinically-evident infection 48 hours after the admission to the healthcare facility. HAIs are the leading causes of illness and death amongst hospitalised patients. A growing number of patients admitted to acute care hospitals acquire one of more HAIs during their stay. Outbreaks of HAIs are possibly more frequent than are identified and/or reported. An outbreak may be defined as an increase in the occurrence of a disease by reference to a recorded baseline rate – although, in practice, timely notification of a possible outbreak often relies on the past experience of clinical and laboratory staff, and on them being alert to the condition of individual patients. Every hospital needs to establish its baseline HAI incidence so that it can identify unusual levels, action thresholds or outbreaks when they occur.

An outbreak may also be identified by cases of infection that are clearly associated by time, place and person. Person may be represented by the same ward type, attending clinical staff or patient demographic. Although outbreaks represent only a small percentage of cases of infection acquired in hospital, any major increase in cases is evidence that an infection has begun to spread and is beginning to pose a possible serious threat to other patients and staff.

Hospitals need to have plans to deal with outbreaks of HAIs. The infection control practitioners in the hospital should be closely involved in drawing up and approving these plans that should form part of the facility’s comprehensive infection prevention and control (IPC) programme. The infection control team must have access to managers and medical and nursing staff who have the authority to take the actions necessary to contain the outbreak. Key elements in prevention of HAIs are implementation of bundles. Regular but ad hoc IPC audits utilizing the National Department of Health’s tool developed from the National Infection Prevention and Control Policy & Strategy (2013).

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