Efforts to Reduce HAIs Meeting with Success

Progress is being made in reducing the number of health care-associated infections (HAIs) according to two reports released by the Center for Disease Control (CDC). An HAI is an infection a person receives while they are in the hospital, in another facility, or under the care of a provider while they are being treated for another condition. Reducing HAIs is a top priority for HHS. In 2009, HHS adopted the National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination and since that time CDC has been reporting on the progress towards meeting those goals.

Progress in General

Based on the most recent data, the CDC reports that one in 25 patients have contracted at least one infection during the course of their hospital stay. In 2011, there were approximately 722,000 according to a report in the New England Journal of Medicine. That number is extrapolated from reported HAIs in 183 hospitals. This number is down from the estimated 1.7 million HAIs estimated in a 2007 report. The report also estimated that about 75,000 people died as a result of their health care-associated infection during 2011. “Although there has been some progress, today and every day, more than 200 Americans with health care-associated infections will die during their hospital stay,” said CDC Director Tom Frieden, M.D., MPH in a statement on the two reports.

The most common HAIs were pneumonia and surgical site infections which each accounted for 22 percent of all HAIs. Urinary tract infections accounted for 13 percent of the HAIs and blood infections accounted for 10 percent of HAIs. The most common germs causing HAIs were C.difficile responsible for 12 percent of HAI infections, Staphylococcus aureus, including MRSA which accounted for 11 percent of HAI infections. Klebsiella and E. coli accounted for 10 and 9 percent respectively of HAI infections.

Patients most likely to acquire an HAI were older, had been in the hospital longer at the time of surgery, were in a larger hospital, had a central line catheter in place, were on a ventilator, or were in critical care, according to the report. Device–associated infections, which have been a major focus of infection prevention in recent decades, accounted for only 25.6 percent of all HAIs. Infections not associated with devices or operations accounted for approximately half of all HAIs.

“Our nation is making progress in preventing healthcare-associated infections through three main mechanisms: financial incentives to improve quality, performance measures and public reporting to improve transparency, and the spreading and scaling of effective interventions,” said Patrick Conway M.D. who is CMS’ Deputy Administrator and CMS’ chief medical officer.  A provision so of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) will impose a 1 percent reduction in payment for the hospitals that are in the top 35 percent of HAIs beginning on October 1, 2015.

Specific Co3nditions

In a second report the CDC said that significant progress has been made in the reduction in a number of HAIs associated with specific procedures. Central line-associated bloodstream infections saw a 44 percent reduction from 2008. Surgical site infections dropped by 20 percent during the same time period for 10 procedures tracked during that time with the most significant reductions in HAIs being associated with cardiac surgeries. There were only small drops of four percent and two percent for hospital-onset MRSA and hospital-onset C. difficle infections respectively. “The most advanced medical care won’t work if clinicians don’t prevent infection through basic things such as regular hand hygiene,” said Frieden.

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