Student Dissertation

Agency : Hospital Acquired Infection; Cost of Care; CAUTI; CLABSI; SSI; VAP

Objective : To calculate the HAI incidence rate among patients admitted in hospital, to compute the total cost incurred by hospital due to HAI in these patients, To ascertain additional out of pocket (OOP) expenditure by patients due to HAI, To take controlled measures to reduce the burden of HAI from the current incidence rate.

Methodology : It was a retrospective analytical and prospective observational study type, Study area was ICU and Wards, Sample size of 96 cases of HAI occur in 2015, Data collected from records maintained by infection control department and prospectively by observation, interviewed with experts and care takers. (Nurses, ICN, Intensivist, Doctors), Data Analysis: In this study, we have taken data of 2015 maintained by infection control committee, total cases of HAI were 96 included 33 cases of Cather associated urinary tract infection (CAUTI), 17 cases of central line associated blood stream infection (CLABSI), 32 cases of surgical site infection (SSI) including 2 cases of vancomycin resistance entericoccus (VRE) and 1 case of Methicilline resistance staphylococcus aureas (MRSA) and 14 cases of ventilator associated pneumonia (VAP). Total average length of stay for CAUTI was 17.4, for CLABSI 19.3, for VAP 44.17 and for multiple infection ALOS was 30.4. ALOS after infection for CAUTI was 6.8, for CLABSI it was 14.7, for VAP it was 29.7 and for multiple infection it was 17.9 days. In SSI there were average days of 15.8 after surgery when the infection becomes positive. HAI mortality rate was 8.33% in a year. Economic impact of HAI shows CAUTI contributes Rs. 50372.71, CLABSI contributes Rs. 76023.22, VAP contribute Rs. 147650.75, Multiple infection contribute Rs. 258337.3. After infection, this cost included antibiotic cost, consultation fee, room rent and nursing charges etc.

Findings : HAI add to the imbalance the recourse allocation between primary and secondary health care by diverting scarce fund to the management of potentially preventable condition.

Recommendations : there is need of Sensitize the severity of the issue and increase education and awareness among health care worker as well as adhere to the standard guidelines for prevention of hospital acquired infection and reduce the burden of economic impact because of HAI. Conclusion: HAI add to the imbalance