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Healthcare associated infections

This section deals with healthcare associated infections (HCAIs) and includes information on some of the most frequently asked questions.

Patients enter hospital either because they are ill or because they require surgery. Both illness and surgery have a direct effect on the immune system and therefore such patients are at an increased risk from infection.

What is a healthcare associated infection?

Healthcare-associated infection (HCAI) refers to infections that occur as a result of contact with the healthcare system in its widest sense - from care provided in your own home, to general practice, nursing home care and care in acute hospitals. The term has recently been coined in recognition that increasingly complex procedures are undertaken outside hospitals. Previously, when most complex healthcare was hospital based, the term hospital acquired infection was used.

What does the term hospital-acquired infection mean?

Hospital-acquired infection (HAI) (also known as nosocomial infection) has a strict definition. It refers to an infection that develops in a patient 48 hours or more after admission to a hospital. Infections that occur within the first 48 hours are considered to have been picked up in the community and were incubating prior to admission. These are then referred to as community acquired infections.

The majority of healthcare acquired infections are acquired from patients’ own micro flora. Indeed, Staphylococcus Aureus is found on the skin or in the noses of approximately 30% of people. Some strains of Staphylococcus Aureus have developed resistance to antibiotics. The most common strain is Methicillin Resistant Staphylococcus Aureus (MRSA). In the majority of patients, MRSA will not cause a problem because it is part of the normal flora residing on the skin.

Healthcare Associated Infections – A Strategy for Hospitals in Wales

The first Welsh Government strategy for tackling HCAIs was published in 2004. The strategy was developed to support the reduction of healthcare associated infections in Wales and to emphasise the responsibilities of all health care workers in reducing these infections.

We are now intending to refresh the strategy in response to the Wales audit report and Assembly audit committee report.

The Wales Audit Office published their ‘Minimising Healthcare Associated Infections in NHS Trusts in Wales’ report on the 8 November 2007. The report described the current position in NHS Trusts in terms of healthcare associated infection rates and the steps that the Trusts have put in place to manage the risk of infection. The report included a number of recommendations for NHS Trusts, the Assembly Government and other stakeholders to consider to continue reducing the rates of healthcare associated infections in Welsh hospitals.

The Wales Office report was scrutinised by the Welsh Government Audit Committee on the 7 February 2008. Following its evidence session, the National Assembly for Wales Audit Committee presented its own report to the Welsh Assembly Government on 7 May 2008.

Visit: Report from Wales Audit Office (external link)

The Health and Social Services Minister responded to the Audit Committee’s report on the 17 June 2008 and accepted the recommendations of the Wales Audit Office and Audit Committee reports.  

Visit: National Assembly for Wales Audit committee report (external link)