Infection Protection

Today’s blog comes from Vicki Buchda, Director, Care Improvement at the Arizona Hospital and Healthcare Association (AzHHA). Ms. Buchda highlights both nationwide and statewide data contained in a new CDC report. For more information on AzHHA’s care improvement efforts, click here.

The Centers for Disease Control (CDC) released a new report, the 2016 Healthcare-Associated Infection Progress Report just in time for International Infection Prevention Week (IIPW). The theme for IIPW is Protecting Patients Everywhere, and the new CDC report focuses not only on acute care patients, but also includes data about how we are doing in preventing healthcare-associated infections in Long Term Acute Care Hospitals (LTACHs) and Inpatient Rehabilitation Facilities (IRFs). The CDC report is easy to view and can be searched by state. The report shows areas of progress and serves to identify areas for continued improvement.

Strides have been made nationally in acute care hospitals with statistically significant decreases from 2015 to 2016 in infections, including:

  • About 11% decrease in central line-associated bloodstream infections (CLABSIs) 
  • About 7% decrease in catheter-associated urinary tract infections (CAUTIs) 
  • About 2% decrease in ventilator-associated events (VAEs) 
  • About 13% decrease in abdominal hysterectomy surgical site infections (SSIs) 
  • About 7% decrease in colon surgery SSIs 
  • About 6% decrease in methicillin-resistant Staphylococcus aureus (MRSA) bacteremia 
  • About 8% decrease in Clostridioides difficile (C. difficile) infections

Arizona hospitals reported statistically significant better performance than the national baseline using a standardized infection ratio (SIR), which is a summary statistic that can be used to track HAI prevention progress over time for:

  • CLABSI (24% less than the national baseline)
  • CAUTIs (31% less than the national baseline)
  • difficile infections (10% less than the national baseline)

Arizona has opportunities in VAEs with a 37% higher (worse) than expected standardized infection ratio than the national baseline.

Nationally in 2016 Long Term Acute Care Hospitals (LTACHs) reported significantly lower (better) SIRs compared to national baseline for CLABSI (4%) and CAUTI (2%). C. difficile events significantly decreased from 2015 to 2016 and were 15% lower than the national baseline. The MRSA bacteremia SIR is similar to national baseline and there was no significant change from 2015 to 2016. VAEs in this group were higher than national baselines.

Arizona LTACHs did not report significant changes from 2015-2016, but are lower (better) than the national baseline for CLABSI (28%), CAUTI (53%), and VAE (41%). MRSA Bacteremia and C. difficile SIRs increased slightly, but are not significantly higher than the national SIRs.

Nationally Inpatient Rehabilitation Facilities (IRFs) reported no significant change in CLABSI s between 2015 and 2106. There was a significant increase in CAUTIs, and the CAUTI SIR is 7% higher (worse) than the national baseline. MRSA bacteremia did not change significantly from 2015-2016, however is it 17% higher than the national baseline. C. difficile events decreased significantly from 2015 and 2016, and are 4% lower (better) compared to national baseline.

Inpatient Rehabilitation Facilities in Arizona did not have significant changes in CLABSI, CAUTI, MRSA bacteremia or C. difficile events between 2015 and 2016. However, C. difficile events are 51% higher (worse) compared to national baseline.

Summary: Arizona acute care facilities are doing better year over year. Acute care hospitals have opportunities in reducing VAEs. Arizona LTACHs are performing well in preventing CLABSI, CAUTI, and VAE. IRFs have opportunities in reducing C. difficile.

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