The Challenge of Post-Acute Compliance with Infection Prevention and Control
© 2025 Joi A McMillon, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Healthcare-acquired infections (HAIs), also known as nosocomial infections, are infections that patients acquire while receiving treatment for other conditions within a healthcare setting. These infections pose a significant challenge to healthcare systems worldwide, affecting millions of patients each year and leading to substantial economic burdens and adverse health outcomes.
Prevalence and Causes
HAIs occur in various healthcare environments, including hospitals, nursing homes, and outpatient clinics. Common types of HAIs include urinary tract infections, surgical site infections, bloodstream infections, and pneumonia. These infections are often caused by bacteria, viruses, or fungi, with antibiotic-resistant strains posing a particular threat.
Several factors contribute to the prevalence of HAIs, including invasive procedures such as catheters, ventilators, and surgical procedures increase the risk of infections. Antibiotic resistance brought on by the overuse and misuse of antibiotics have led to the rise of resistant strains, complicating treatment. Facilities with high patient turnover can facilitate the spread of infections. Patients with weakened immune systems are more susceptible to infections.
Health and Economic Consequences
The impact of HAIs is profound, affecting both individual patients and healthcare systems. HAIs can lead to prolonged hospital stays, increased morbidity and mortality, and long-term disability. They complicate treatment plans and often require additional interventions, such as the use of more potent antibiotics.
The financial impact of HAIs is significant, with increased costs due to extended hospital stays, additional diagnostic tests, and treatments. In the United States alone, HAIs cost billions of dollars annually in healthcare expenses. HAIs contribute to the growing problem of antibiotic resistance, as infections caused by resistant strains are harder and more expensive to treat.
Prevention Strategies
Preventing HAIs requires a multifaceted approach, integrating policy, education, and technology. Strict adherence to hand hygiene, sterilization procedures, and the use of personal protective equipment are crucial. Effective monitoring systems help track infection rates and identify outbreaks, enabling timely interventions. Responsible use of antibiotics can curb the development of resistant strains. This includes prescribing antibiotics only when necessary and ensuring the appropriate use of broad-spectrum antibiotics. Continuous education for healthcare workers on infection prevention and control measures is essential. Regular cleaning and disinfection of healthcare environments reduce the risk of pathogen transmission.
The Disparities between Acute & Post Acute Infection Prevention Programs
Acute care hospitals have many differences in infection control resources than post-acute care settings such as long-term acute care facilities, inpatient rehabilitation hospitals, skilled nursing facilities and long-term care facilities. A big factor in the difference between the programs are the lack of resources in post-acute care facilities. Acute care hospitals provide an array of services that help provide the much-needed revenue to fund the proper staffing and technologies to help prevent the spread of infections. Most have a team of qualified infection preventionists, [equipped with advance technologies including those utilizing UV light], that can ensure the prevention of HAIs. New innovations are required to be implemented to take the human error factor into account and automate disinfection practices. Emerging technologies such as GermPass has been proven to provide automatic decontamination for all high touch surfaces. These advantages help the facilities combat HAIs.
After much advocacy long term care facilities have been required by regulatory authorities to have a dedicated infection preventionist that provides at least 20 hours per week dedicated to infection prevention responsibilities. Unfortunately, the facilities range in size from 80-450 beds. There is no required scaling of staffing to the size of the facility. Compounding the problem is also the lack of qualified individuals for the position. Many infection preventionists have been given the responsibility in addition to multiple roles such as Directors of Nursing, Assistant Director of Nursing, and Staffing Development Coordinators. Most have no formal training in infection prevention and control or needed certifications. While acute hospitals have the margins to be able to afford emerging technologies, long term care facilities cannot afford U.V. technologies, and their programs must rely on strong basic infection control practices of health care workers and environmental services staff. Monitoring of these practices are critical to preventing healthcare acquired infections, and sadly the challenge is that these duties fall second to other competing priorities. This makes it more difficult to manage proper infection prevention programs. Instead of multiple technology based resources acute care facilities, post-acute care facilities have to rely on basic inexpensive products such as glow germ to monitor for compliance with hand washing and environmental cleaning. It is crucial that advocacy continues to ensure the safety provided by post-acute can be maintained by having the proper staffing and resources to prevent healthcare acquired infections [1-7].
Conclusion
The impact of healthcare-acquired infections is far-reaching, affecting patient safety, healthcare costs, and public health. While challenges remain, ongoing efforts in infection control, education, and research are vital to reducing the incidence of HAIs and mitigating their impact. In conclusion, the disparity in infection control resources between acute care hospitals and post-acute care settings is significant, primarily due to differences in funding and access to advanced technologies. While acute care hospitals benefit from robust staffing and cutting-edge tools like U.V. technologies, post-acute care facilities often struggle with limited resources and personnel who juggle multiple roles without specialized training. This gap highlights the urgent need for continued advocacy to ensure these facilities receive the necessary support and resources. By prioritizing proper staffing and implementing basic, cost- effective infection control practices, post-acute care settings can enhance their ability to prevent healthcare-acquired infections and safeguard patient health.
References
- Centers for Disease Control and Prevention (2021) Healthcare-associated infections.
- World Health Organization (2020) Report on the burden of endemic health care-associated infection worldwide https://who.int/infection-prevention/publications/burden_hcai/en/.
- Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, et (2014) Multistate point-prevalence survey of health care–associated infections. New England Journal of Medicine 370: 1198-1208.
- Weinstein RA, Hota B (2004) Contamination, disinfection, and cross-colonization: Are hospital surfaces reservoirs for nosocomial infection? Clinical Infectious Diseases 39: 1182- 1189.
- Tacconelli E, Pezzani MD (2019) Public health burden of antimicrobial resistance in Europe. The Lancet Infectious Diseases 19: 4-6.
- Glo Germ (n.d.) (2025) Glo Germ: Visual tool for handwashing training, aseptic techniques, and general infection control https://www.glogerm.com/.
- Micro Lumix (n.d.) (2025) GermPass: Infection preventionsolutions https://microlumix.com/germpass/.