The widespread impact of poor infection prevention and control policies and bad prescribing practices on hospital-acquired infections : who is liable?

Abstract

Hospital-acquired infections, also known as nosocomial infections, are defined as an infection acquired in hospital by a patient who was admitted for a reason other than that infection. There are three main methods in which nosocomial infections may be transmitted to the patient, namely through direct physical contact, droplet spread and through airborne microorganisms. Infection control and prevention strategies are pivotal in the containment of nosocomial infections in healthcare establishments. The emergence and persistence of nosocomial infections are aided by inadequate infection control and prevention policies. Healthcare establishments must implement standard precautions to minimise the risk of infection transmission, these precautions include hand hygiene, disinfection, sterilization, protective equipment and injection safety. Antimicrobial resistance is an increasing threat to the successful treatment of nosocomial infections. Antimicrobial resistance is associated with the excessive use of antimicrobial agents. Measures such as antimicrobial de-escalation, the use of local epidemiology and antibiotic susceptibility patterns and shortening the duration of antibiotic therapy have the potential to reduce antimicrobial resistance. The World Health Organisation places a duty on all health care provides to prevention the transmission of infection and provides specific responsibilities for all healthcare works. The South African health care system is regulated by the Constitution, legislation, precedents, medical ethics and the Health Professions Council of South Africa which place a duty on a medical practitioner to exercise his or her duties with a certain degree of care and skill. A medical practitioner and/or healthcare establishment may be held legally liable for the harm caused by a medical practitioner who does not exercise the degree of care and skill required of him or her.