Healthcare News & Insights

Infections: Where hospitals stand right now

sb10069454j-001Good news! The rates of several types of hospital acquired infections (HAIs) have dropped significantly, according to a new report from the Centers for Disease Control & Prevention (CDC), which looks at hospital infection rates from 2013.

Most notably, the rates for central line-associated bloodstream infections (CLABSI) dropped by 46%. And surgical site infections (SSI) decreased by 19% for the 10 procedures tracked in the report, including colon surgery, hip arthoplasty and abdominal hysterectomy.

Other decreases to note: C. difficile (C. diff) infections decreased by 10%, and methicillin-resistant Staphylococcus aureus (MRSA) dropped by 8%.

Performance by state

The CDC tracks the prevention of hospital-acquired infections using a standardized infection ratio, measuring whether a given year’s infection rates are higher, lower or equal to the national baseline.

Breaking performance down by state gives mixed results. While 26 states performed better than the national baseline for infection rates on at least two infection types, 19 performed worse. Sixteen states outperformed the national baseline on at least three infection types, but eight states were worse performers.

Nationally, when looking at hospital’s performance as a whole, between 3% and 12% of facilities had a standardized infection ratio that was higher than the national baseline ratio for at least one of the infections studied in the report.

The CDC plans to work with facilities in these states to reduce these numbers through training and other types of assistance, including connecting hospitals with state health departments and promoting the use of the Comprehensive Unit-based Safety Program (CUSP), a government-endorsed program to boost patient safety by promoting better teamwork among clinical staff.

Areas to improve

Despite the general good news, hospitals still haven’t met the goals set by the CDC in its HAI Action Plan, released in 2009. Additionally, there was a 6% increase in catheter-associated urinary tract infections (CAUTI), though early data from this year is showing that these infections may be finally declining.

So there’s still much work to be done.

With 1 in every 25 patients contracting an infection in the hospital every day, it’s crucial to continue to take strides to reduce infections.

Reporting data is the first step toward solving the problem. While some states don’t have mandated reporting in place for hospital-acquired infections, the option is available for all hospitals. And according to the CDC, tracking these infections is key to increasing awareness and creating effective infection control programs.

In fact, rates of certain infections can decrease by more than 70% if facilities are aware of any infection problems and use that knowledge to take specific steps to prevent them, states the CDC.

Prevention guidelines

The CDC also has a list of best practices hospitals can follow to prevent the infections reviewed in the report.

For CAUTIs, the infections that hospitals are having the most difficulty controlling, the agency recommends that facilities only insert catheters when absolutely necessary, and take them out as soon as possible.

Catheters should be inserted using an aseptic technique with sterilized equipment. Only clinicians who are trained on proper insertion and maintenance for catheters should handle them, and staff should be sure to follow correct hand-hygiene protocol.

With surgical site infections, there are several things hospitals can do to prevent them before surgery, including treating remote infections whenever possible before performing elective procedures, avoiding hair removal at the operative site unless absolutely necessary, and using the appropriate antiseptic agent and technique to prepare the patient’s skin for surgery.

During surgery, keeping the doors to the operating room closed as often as possible helps prevent the spread of germs. And after surgery, staff must be sure to protect the patient’s primary closure incisions with sterile dressing, control the patient’s blood glucose level during the immediate post-operative period and monitor the patient’s antibiotic dose closely.

When it comes to preventing CLABSIs outside of the ICU, clinical staff should remove unnecessary central lines, follow the correct practices for insertion, use the appropriate agent for skin antisepsis, choose a proper site for central line insertion and perform the correct disinfection for the hub/access port.

The CDC also provides guidelines for preventing MRSA and C. diff, including following hand-hygiene and disinfection procedures, educating staff and patients about prevention, and quickly performing and acting on any test results showing the presence of the illnesses.

Be sure your hospital is following the agency’s infection prevention guidelines in its own infection control plan.

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