This article is more than 5 years old. Information may no longer be current.
Q&A: HAIs have social, emotional impacts on patients
Click Here to Manage Email Alerts
In 2011, an estimated 4% of acute-care patients in the United States acquired a health care-associated infection, or HAI, according to researchers. The burden from 2011 to 2012 in Europe was 6%. Although much research has explored the global burden and prevalence of HAIs, the impact on patients has been relatively undocumented, researchers said.
To assess common experiences for patients with a HAI, Kay Currie, PhD, professor of nursing and applied health care research at Glasgow Caledonian University in Scotland, and colleagues conducted a qualitative systematic review using data from 17 studies that took place between 2001 and 2017 and addressed five common HAI types across five countries. The study, published in the American Journal of Infection Control, addresses patient experiences of colonization and infection from HAI-causing bacteria.
The researchers observed four interrelated themes, which included “the continuum of physical and emotional responses, experiencing the response of health care professionals, adapting to life with an HAI, and the complex cultural context of HAI.”
Infectious Disease News spoke with Currie about the role of a clinician when dealing with patients with these infections, common emotional experiences of patients and the importance of the infection control specialist. – by Marley Ghizzone
Why is it important that clinicians know what patients with HAIs are experiencing?
Clinicians are very busy people, often working under pressure. Whilst focusing on the physical aspects of disease management it is easy to forget, or difficult to find time, to respond to the emotional and psychological needs of patients who are experiencing an HAI. Without adequate information and sensitive communication, patients suffer unnecessary distress, which may impede their full recovery.
What emotional experiences are common among patients with HAIs and how do they impact care?
The type of emotional response varies depending on the type of HAI being experienced, but fear, anxiety, uncertainty [and] depression have all been expressed. Patients who are found to be colonized with antibiotic resistant organisms also describe feelings of shame, being stigmatized, [feeling] “unclean,” “like a leper,” with excessive concerns regarding possible transmission of infection to others, even on discharge home.
How do health care providers (HCPs) factor in these experiences?
A common finding in the studies we reviewed was the lack of information provided by health care professionals. Patients often felt that ward-based staff did not understand the infection themselves therefore could not give helpful explanations to patients. In more extreme examples, interactions with HCPs were highly stigmatizing, with patients being made to feel dirty, contagious and [like] a nuisance. Patients were often not given appropriate information on discharge and were left uncertain how to manage, with some taking excessive and unnecessary precautions in the community setting. These negative experiences were lessened where patients were able to speak to an infection prevention control specialist when in hospital and accurate and constructive information and advice was provided.
How can HCPs improve the experience of these patients?
The role of the infection control specialist is important, both in speaking to individual patients and in providing education and support to ward-based staff who care for patients on a daily basis. This should mean that appropriate and proportionate precautions are taken consistently. It is vital that patients are given accurate information, both verbally and in written formats that can be referred to later. The need for infection control precautions such as isolation, protective clothing, etc., should be explained sensitively and care should be taken to avoid the patient feeling personally responsible or stigmatized for having an HAI. Planning for discharge should ensure that patients are given relevant advice on the level of additional precautions, if any, that are needed once they are at home. All of this care to improve the patient experience takes time and expertise and sufficient resources must be available to provide effective person-centered care which maximizes recovery.
What is the take-home message of the analysis?
People who experience an HAI or are colonized with a resistant organism are not to “blame” — it is not their fault. HAIs are an extra, unsolicited blow in their care experience and they need professional support to overcome this. HCPs need ongoing training and access to current information on managing HAI and colonization in order to provide effective support to affected patients. Infection prevention control specialists are pivotal in ensuring accurate information and advice is available. In an era of multiple drug-resistant organisms, processes for identifying colonization and managing HAI will be increasingly important; however, the patient experience of care must not be overlooked.
References:
Currie K, et al. Am J Infect Control. 2018;doi:10.1016/j.ajic.2017.11.023.
Disclosures: Currie reports no relevant financial disclosures.