Health care–associated infections in burn patients, from ventilator-associated pneumonia to skin and soft tissue infections, can substantially compromise outcomes, because these complications are associated with longer lengths of stay, increased morbidity and mortality, and greater direct medical costs. Health care–associated infections are largely preventable, through surveillance, education, appropriate hand hygiene, and culture change, especially for device-related infections. Systems-based practice, which allows individuals and clinical microsystems to navigate and improve the macro health care system, may be one of the most powerful skill sets to effect change, permitting a shift in culture toward patient safety and quality improvement.
Key points
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Age, size of burn, and presence of inhalation injury remain the key predictors of outcome after thermal injury, but the development of health care–associated infections (HAIs) compromises outcomes and increases morbidity and mortality.
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Many HAIs can be prevented, through rigorous application of patient safety protocols, standardization of care, vigilant monitoring, and quality improvement initiatives.
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Systems-based practice serves as both an analytical tool and an interventional opportunity, in which an individual provider, functioning across interconnected microsystems, can leverage those relationships to improve the function of the larger health care system.
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