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Selected Category: State HAI Prevention

Despite Progress, three-quarters of a million infections threaten hospital patients each year

Categories: Antimicrobial Resistance, BSIs, CAUTI, CLABSI, Clostridium difficile, Healthcare-associated infections, Long Term Care (LTC), NHSN, State HAI Prevention

National and State Healthcare-associated Infections Progress Report. This report is based on 2012 data, Published March 2014

National and State Healthcare-associated Infections Progress Report. This report is based on 2012 data, Published March 2014

Despite Progress, three-quarters of a million infections threaten hospital patients each year
National and state data detail threat of healthcare-associated infections and opportunities for further improvements.

CDC released two reports today – one, a New England Journal of Medicine (NEJM) article detailing national healthcare-associated infection estimates, and the other an annual report on national and state-specific progress toward U.S. Health and Human Services HAI prevention goals. Together, the reports show that progress has been made in the effort to eliminate infections that commonly threaten hospital patients, but more work is needed to improve patient safety.

The NEJM article updates the burden numbers for healthcare-associated infections in hospitals.  On any given day, 1 of every 25 patients had 1 or more infections related to their hospital stay.   That means about 722,000 infections a year related to medical care.  One of every 9 patients who gets an infection will die during their hospitalization.

This article sounds the alarm about threats we need to address now.  It tells us that lung infections, gut infections, surgical infections and infection from urinary catheters are harming the most patients.

Some of the top pathogens attacking patients are: 

  • C. difficile, or deadly diarrhea,
  • Staph, including the drug-resistant type known as MRSA,
  • a family of germs known as Enterobacteriaceae, that includes CRE the “nightmare bacteria,”

The second report, CDC’s National and State Healthcare-associated Infection Progress Report, includes national and state-by-state summaries of infection types that are commonly required to be reported to CDC. The Progress Report looked at data submitted to CDC’s National Healthcare Safety Network (NHSN), the nation’s healthcare-associated infection tracking system.   On the national level, the report found a:

  • 44 percent decrease in central line-associated bloodstream infections between 2008 and 2012
  • 20 percent decrease in infections related to the 10 surgical procedures tracked in the report between 2008 and 2012
  • 4 percent decrease in hospital-onset MRSA bloodstream infections between 2011 and 2012
  • 2 percent decrease in hospital-onset C. difficile infections between 2011 and 2012
  • 3 percent increase in catheter-associated urinary tract infections

At the federal and state levels, CDC uses this information to find facilities that need help and target resources where they are most needed.

To access both reports and to see the updated healthcare-associated infection data, see CDC’s website: www.cdc.gov/hai.

Watch a new video on Healthcare-Associated Infections.

What Happens in the Outpatient Clinic Doesn’t Always Stay in the Outpatient Clinic: Lessons from a Regional Outbreak of Adenovirus-associated Epidemic Keratoconjunctivitis (EKC)

Categories: Healthcare-associated infections, Outpatient Care, State HAI Prevention

Andrew Wiese, MPH

Andrew Wiese, MPH

Author – Andrew Wiese, MPH
Applied Epidemiology Fellow
Tennessee Department of Health
CDC, Council of State and Territorial Epidemiologists (CSTE)

This week’s Morbidity and Mortality Weekly Report (MMWR) includes a description of six separate outbreaks of Adenovirus-associated epidemic keratoconjunctivitis (EKC) in four different states. These outbreaks were mainly associated with outpatient eye care.

Last August, as a new CDC/CSTE Applied Epidemiology fellow in the Tennessee Department of Health (TDH), I experienced firsthand an outbreak that was similar to those described in the MMWR. We were contacted by a concerned patient who experienced severe conjunctivitis after receiving care at a local ophthalmology clinic and was aware of similarly affected patients.  I was asked to help lead the investigation.

Communication with the clinic identified gaps related to cohorting of suspected cases, procedures for disinfection of equipment and surfaces, and the policy for the appropriate length of time ill staff should be kept from patient contact.  Our TDH team then guided implementation of appropriate infection control practices to prevent further transmission.  While our investigation identified ninety cases of EKC at the clinic, only a single case from the clinic occurred after the health department’s intervention.

California Initiative Promotes Appropriate Use of Antimicrobials in Healthcare Facilities

Categories: Antimicrobial Resistance, State HAI Prevention

Dr. Trivedi

Dr. Trivedi

Author – Dr. Trivedi,
California Antimicrobial Stewardship Program Initiative,
California Department of Public Health.

In February 2010, the California Department of Public Health (CDPH) launched the country’s first statewide initiative to promote optimization of antimicrobials in healthcare facilities. In less than two years, the cutting-edge California Antimicrobial Stewardship Program (ASP) Initiative is helping California healthcare facilities establish programs to improve patient safety and quality.

The Healthcare Associated Infections (HAI) Program of CDPH developed the statewide California Antimicrobial Stewardship Program (ASP) Initiative as the result of a statutory mandate. California Senate Bill 739 required CDPH to ensure that each general acute care hospital assemble a quality improvement committee to oversee the results of a process for evaluating the judicious use of antibiotics. While hospitals were aware of this mandate, they were left to implement programs on their own. The Initiative offers California healthcare facilities a valuable resource for antimicrobial use education, guidance and consultation.

NY State collaborative – a groundbreaking Antimicrobial Stewardship Project for hospitals and long-term care

Categories: Antimicrobial Resistance, Healthcare-associated infections, State HAI Prevention

David P. Calfee, MD, MS

David P. Calfee, MD, MS

Author – David P. Calfee, MD, MS
Associate Professor of Medicine and Public Health at Weill Cornell Medical College,
Chief Hospital Epidemiologist at New York-Presbyterian Hospital/Weill Cornell in New York City

The GNYHA, UHF, and NYSDOH Antimicrobial Stewardship Project

While most discussions of antibiotic resistance and improving antibiotic prescribing practices (“antimicrobial stewardship”) focus on hospitals, antibiotic resistance and inappropriate antibiotic use are also prevalent in long-term care facilities (LTCFs). In fact, antibiotic resistance rates in LTCFs are often higher than in hospitals. Consequently, in 2009 the Greater New York Hospital Association, United Hospital Fund, and New York State Department of Health launched the Antimicrobial Stewardship Project.

The project pursued effective strategies for antimicrobial stewardship programs in LTCFs to demonstrate that beneficial activities could be performed without significant investment in new resources, and to demonstrate the value of hospital-LTCF partnerships in antimicrobial stewardship activities. Another goal was to develop tools and materials to assist project participants and other healthcare facilities to develop and manage their antimicrobial stewardship programs.

Taking GRIME out of South Carolina

Categories: Hand Hygiene, Healthcare-associated infections, State HAI Prevention

Dixie Roberts, APRN, C, MPH

Dixie Roberts, APRN, C, MPH

Author – Dixie Roberts, APRN, C, MPH
Healthcare Associated Infections Coordinator
South Carolina Department of Health and Environmental Control

“He who doesn’t prevent grime when he can, encourages it”

In 2007, with the knowledge that hand hygiene compliance is directly related to hospital acquired infections (HAIs), the South Carolina Hospital Association (SCHA) launched the first statewide hand hygiene campaign in alignment with the World Health Organization’s (WHO) international hand hygiene campaign. DHEC, AARP, Mothers Against Medical Error and APIC- Palmetto Chapter soon joined the effort.

This campaign had to be engaging in order to be successful. We selected the theme “Grime Scene Investigators: South Carolina” (GSI:SC), a parody on the popular television series CSI. Enthused about our initiative, the South Carolina Chapter of HOSA and the South Carolina Department of Education joined our effort.

In July 2009 a “summons” was sent to hospital infection prevention and marketing departments and public health regions calling them for training in Grime Scene Investigation. Each hospital received a GSI:SC kit with everything needed to set up a “grime scene” to create awareness while educating people on proper hand hygiene and its importance. Every SCHA member facility and public health region demonstrated their support of the campaign by designating a point of contact.

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