1. Key Clinical Terms for the Finance Professional-Hospital Acquired Conditions 1

2. What is a HAI? Hospital-acquired infection: An infection caught while hospitalized. The medical term for a hospital-acquired infection is "nosocomial." Most nosocomial infections are due to bacteria. Since antibiotics are frequently used within hospitals, the types of bacteria and their resistance to antibiotics is different than bacteria outside of the hospital. Nosocomial infections can be serious and difficult to treat. A nosocomial infection is strictly and specifically an infection "not present or incubating prior to admittance to the hospital, but generally occurring 72 hours after admittance." The word "nosocomial" is made up of two Greek words. The prefix "noso-" comes from "nosus" meaning disease and "-comial" comes from "komeion" meaning to take care of. Nosocomial could therefore refer to any affliction acquired by a patient while under medical supervision, but it doesn't. It now refers more narrowly to a hospital-acquired infection Retrieved from www.medterms.com 2

3. What is C Diff What is Clostridium difficile (C. difficile) colitis? Antibiotic-associated (C. difficile) colitis is an infection of the colon caused by C. difficile that occurs primarily among individuals who have been using antibiotics. It is the most common infection acquired by patients while they are in the hospital. More than three million C. difficile infections occur in hospitals in the US each year. After a stay of only two days in a hospital, 10% of patients will develop infection with C. difficile. C. difficile also may be acquired outside of hospitals in the community. It is estimated that 20,000 infections with C. difficile occur in the community each year in the U.S. Retrieved from www.medterms.com 3

4. What is MRSA? What is methicillin-resistant Staphylococcus aureus (MRSA)? MRSA stands for methicillin-resistant Staphylococcus aureus (S. aureus) bacteria. This organism is known for causing skin infections in addition to many other types of infections. There are other designations in the scientific literature for these bacteria according to where the bacteria are acquired by patients, such as community-acquired MRSA (CA-MRSA or CMRSA), hospital-acquired or health-care-acquired MRSA (HA-MRSA or HMRSA), or epidemic MRSA (EMRSA). Statistical data suggest that as many as 19,000 people per year die from MRSA in the U.S.; current data suggest this number has declined by about 25%-35% in recent years, in part, because of prevention practices at hospitals and home care. Although S. aureus has been causing infections (Staph infections) probably as long as the human race has existed, MRSA has a relatively short history. MRSA was first noted in 1961, about two years after the antibiotic methicillin was initially used to treat S. aureus and other infectious bacteria. Retrieved from www.medterms.com 4

5. What is VRE? What is vancomycin-resistant enterococcus (VRE)? Bacteria normally found in the feces of people and many animals. Two types of enterococci -- Enterococcus faecalis and Enterococcus faecium --occasionally cause human disease, most commonly urinary tract infections and wound infections. Other infections, including those of the blood stream (bacteraemia), heart valves (endocarditis) and the brain (meningitis) can occur in severely ill patients in hospitals. Enterococci also often colonize open wounds and skin ulcers. Enterococci are among the most common antibiotic-resistant bacteria. The first vancomycin-resistant enterococcus (VRE) was found in 1986. Since that time, VRE has become a growing problem. Bacteria resistant to vancomycin are commonly also resistant to a similar antibiotic called teicoplanin, and vice versa. Retrieved from www.medterms.com 5

6. What is UTI? CAUTI? What is a urinary tract infection (UTI)? An infection in the urinary system that begins when microorganisms cling to the opening of the urethra (the canal from the bladder) and begin to multiply. Most UTIs are due to one type of bacteria, E. (Escherichia) coli, a normal denizen of the colon. An infection in the urethra leads to inflammation called urethritis. From there bacteria may move up, causing a bladder infection (cystitis) and if the infection is not treated promptly, bacteria may go up the ureters to infect the kidneys (pyelonephritis). Factors leading to UTI include any abnormality of the urinary tract (such as a urinary tract malformation or a kidney stone) that obstructs the flow of urine, an enlarged prostate gland that slows the flow of urine, catheters (tubes) in the bladder, diabetes (due to changes of the immune system), and any disorder that suppresses the immune system. Retrieved from www.medterms.com 6

7. Sources u Hancock, Melinda, and Charles, Tim, Process Re-Engineering for Better Patient Outcomes and Internal Efficiencies, HFMA Leadership Conference, April 1, 2011 (slides 51-55) u www.medterms.com 7