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Preventing health care associated infections 141

abdominal hysterectomy, vaginal hysterectomy, coronary artery bypass
graft, other cardiac surgery, peripheral vascular bypass surgery, and ab-
dominal aortic aneurysm repair).
5. There was an 8% decrease in hospital-onset C diff infections between
2011 and 2014.
6. There was a 13% decrease in hospital-onset methicillin-resistant
Staphylococcus aureus (MRSA) bacteremia between 2011 and 2014 [8].
Steps can be taken to control and prevent HAIs from occurring. It has
been shown that specific target HAIs can be decreased by as much as 70%
when HCF teams are aware of infection problems and take specific steps to
prevent infections. Preventing HAIs is possible, but it takes a conscious ef-
fort of everyone involved in the patient’s care to address the issue. A success-
ful program to address preventing HAIs requires a systematic approach: the
health-care facilities, their employees, public health, quality improvement
groups, the Federal Government, and the patient all working together. See
section on Preventing HAIs later in this chapter for additional information
on steps that can be taken to prevent HAIs from occurring.

6.4.1 Patient-related factors
Several patient-related factors need to be considered when looking at how
diseases are transmitted. Many factors including patient characteristics,
influence whether an infectious disease will be transmitted to a person.
Infectious disease transmission can be thought of as a chain with each link
in the chain needed before the infection will be transmitted. Each of the
following links must be present before an infection can be transmitted:
• Source of microorganisms
• Susceptible host and
• Means of transmission
There are several ways to break each of these links in disease transmis-
sion. Steps can be taken to remove the source of microorganisms. People
can improve nutrition, get exercise, and get sufficient sleep to improve their
immune systems and reduce their susceptibility as a host. Personal protective
equipment can be used to prevent patients from being exposed as well as
health-care workers and others exposing the patient to new microbes.

6.4.1.1 Source of microorganisms
People are a major source of microorganisms which are a part of a person’s
normal body flora. Most of these organisms are necessary for each of us
to live and be healthy. However, it is also possible for pathogenic microor-
ganisms to colonize on a patient. Infections can be transmitted from other