Effects of nosocomial infections on health workers
In healthcare delivery, the health workers become infected with the same diseases they are fighting. Such an occurrence becomes the case of the attacker becoming the attacked or the predator becoming the prey.
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Both health workers and their patients become victims of hospital acquired infections, especially when the clinical protocols relating to infection prevention and control (IPC) are not in place or they are put in place but not adhered to as required.
Hospital acquired infections are referred to as nosocomial infections. In this article thus, I have explored the effects of nosocomial infections on the health workforce. It would be recalled, for example, that a Japanese called Dr Hideyo Noguchi died of yellow fever in Ghana in 1928 while he was helping to fight the same disease. He was said to have been infected with the yellow fever virus from an infected person’s blood sample in the laboratory. This was a seminal case of a deadly nosocomial infection.
Nosocomial Infectious
As indicated earlier, a nosocomial infection basically refers to an infection a person acquires in the hospital environment. Accordingly, Benenson (1995) defined nosocomial infection as an infection occurring in a patient or a health worker in a hospital or other health facility in whom the infection was not present or incubating at the time of admission or prior to working in the hospital environment. Among in-patients, nosocomial infections may manifest even after such patients have been discharged while the health workers have it as an occupational infection.
Nosocomial infection types may include central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), surgical site infections (SSI), ventilator-associated pneumonia (VAP) as well as bacterial, fungal, viral and gastrointestinal infections.
Also, nosocomial infections may manifest in the form of surgical wound infection, urinary tract infection, respiratory tract infection, vascular catheter infection, septicaemia, gastroenteritis, sinusitis, skin and soft tissue infection as well as endometritis and other infections occurring after childbirth.
Suffice to say that many different pathogens may cause nosocomial infections. The infecting organisms vary among different patient populations, healthcare settings and countries.
Contributing factors, frequency and impact
Nosocomial infections are a global phenomenon in both developed and resource-poor countries, affecting both patients and health workers even to the point of death. The World Health Organisation (WHO) reported that about 1.4 million people worldwide suffer from nosocomial infections yearly.
The WHO also observed that surgical wound, urinary tract, and lower respiratory infections are the most common nosocomial infections globally. Nosocomial infections occur frequently in intensive care units, infectious wards, emergency units and in acute surgical as well as orthopaedic wards.
Hospital acquired infections add to functional disability and emotional stress of the patient and the health worker, and the infections may, in some cases, lead to impairments that reduce the quality of life. The increased use of drugs, the need for isolation, and the use of additional laboratory and other diagnostic studies also contribute to associated financial burdens.
Nosocomial infections equally add to the imbalance between resource allocation for primary and secondary health care by diverting scarce funds to the management of potentially preventable conditions.
Effects on health workers
The COVID-19 pandemic and other recent large disease outbreaks have significantly heightened the extent to which healthcare settings can contribute to the spread of infections, harming patients, health workers and visitors, if insufficient attention is paid to infection prevention and control (IPC). Whenever the health workers fall victim of nosocomial infections, their number reduces due to morbidity and mortality, and this increases the workload for their working colleagues thereby affecting patient care in diverse ways.
In their bid to treat patients and provide cure therefore health workers themselves become infected with the same diseases they treat. This is why beyond the adherence to the infection prevention and control measures, governments must put insurance and other packages in place for the safety and welfare of health workers. In Ghana, such an arrangement is lacking in the public sector hence the Ghanaian public sector health workers are at risk despite the meagre salaries they receive.
The non-availability of an insurance or provident fund for the Ghanaian public sector health worker depicts the government’s disregard for the health of the health workers. It is high time they it started to think about the health care of Ghanaian health workers.
Perhaps, another impediment is that the Ghanaian health workers in the public sector are themselves not united and they are pursuing such interests on a cynical basis with each of the numerous professional associations undermining the rest. This stark trend of affairs also makes the government take an unfair advantage of health workers.
Recommendation
Empirical studies across the globe have revealed that nosocomial infections are a major cause of morbidity and mortality among health workers and in-patients. A high frequency of nosocomial infections is evident of poor quality of health service delivery and it leads to avoidable costs.
Many factors contribute to the frequency of nosocomial infections. Notable among them are hospitalised patients who are immunocompromised, compromised patient care practices, non-adherence to IPC protocols etc.
These contributing factors in the healthcare delivery spectrum facilitate the transmission of microorganisms among patients and their care givers. The selective pressure of intense antibiotic use also promotes antibiotic resistance leading to impediments in fighting emerging nosocomial infections.
Ghana lacks an insurance package for its health workers in the public sector who become infected in the line of duty. Most often than not, such workers care for themselves with their salaries. No national policy is in place and implemented for the welfare of health workers in Ghana.
Meagre conditions of service are decentralised with funding from health facility internally generated funds which are not even adequate for running the hospitals.
To me, the Ghanaian public sector health worker deserves a welfare package that makes provision for morbidities and mortalities resulting from nosocomial infections. The government must, therefore, make this a priority on the national agenda. Simultaneously, health workers themselves must eschew cynicism and push in unison for better conditions of service. Failure to unite for this important interest gives an upper hand to government not to take seriously, issues relating to health workers’ welfare in their line of duty.
Nosocomial infection prevention also calls for investment in barrier nursing care and the general use of personal protective equipment (PPEs).
The writer is a Hospital Administrator
Email: [email protected]
