Health care-associated infections

Health care-associated infections, or HAIs, are among the top 10 causes of death in the United States and cost in excess of $20 billion a year.  These infections are acquired by patients during the course of receiving treatment for other conditions within a health care setting, including hospitals, nursing homes, ambulatory surgical centers, and community clinics.  Many of these infections are preventable with appropriate health care practices. The Agency for Healthcare Research and Quality reports that “Adults who develop health care-associated infections (HAIs) due to medical or surgical care while in the hospital have to stay an average of 19 days longer than adults who don’t develop an infection.”  (http://www.hcup-us.ahrq.gov/reports/statbriefs/sb94.jsp)

The infections that account for the majority of health care-associated infections include:

• Blood stream infections associated with intravascular catheters
• Surgical site infections (SSIs)
• Infections associated with urinary catheters
• Pneumonia associated with mechanical ventilators

Two important organisms in the area of health care-associated infections are Clostridium difficile and Methicillin Resistant Staphylococcus aureus (MRSA).  Overuse of antibiotics can contribute to rising rates of these types of infections.  Hand hygiene, which includes hand-washing and the use of alcohol-based hand sanitizer, is one of the most important pieces of HAI prevention.  The following links provide more information about hand hygiene:

Centers for Disease Control and Prevention: Hand Hygiene in Healthcare Settings http://www.cdc.gov/handhygiene/
Hand Hygiene Resource Center http://www.handhygiene.org/
Illinois Department of Public Health Hand-washing Poster http://www.idph.state.il.us/about/fdd/HandWash2.pdf

National Action Plan to Prevent Health Care-associated Infections

In 2009, the U.S. Department of Health and Human Services issued an “Action Plan to Prevent Health Care-Associated Infections” in an effort to combat this growing problem. The action plan calls for a national approach to reduce the transmission of disease, development of strong partnerships between federal and local governments for prevention, and education of providers and other health care personnel in the best prevention practices to reduce these infections. The action plan also includes specific national targets for reduction of key health care-associated infections and a call to educate the public about these infections and how to prevent them..

In concert with the national initiative, the Illinois Department of Public Health (the Department) applied for and was awarded $853,400 through the American Recovery and Reinvestment Act of 2009. The funding is being used over two years to enhance HAI prevention efforts across the state of Illinois.  As a result, the Department has created an HAI Prevention Advisory Council with key stakeholders, hired an HAI coordinator and developed a focused Illinois HAI Prevention Plan.

Illinois HAI Prevention Plan

The comprehensive Illinois HAI Prevention Plan details goals for the state over the next five years that are in line with the national initiative.  Specific HAI targets have been prioritized including efforts to prevent Central Line-Associated Bloodstream Infections (CLABSI), Surgical Site Infections, Clostridium difficile (C-difficile), and Methicillin-resistant Staphylococcus aureus (MRSA).  Goals have been set in four key areas:

1. Expand Illinois HAI surveillance, detection and reporting. This includes expanding state-wide reporting of HAIs in hospitals through the CDC’s National Health Safety Network (NHSN) surveillance system.  Effective surveillance is essential to HAI identification and monitoring.
2. Enhance development of automated HAI laboratory and surveillance reports.  This will foster accurate monitoring of HAIs and reduce the work burden placed on health care infection prevention workers.
3. Establish a Clostridium difficile quality improvement collaborative at 20 different hospitals across the State.  Quality Improvement collaboratives help health care systems and workers implement infection reduction practices.  These practices can have a dramatic impact on reducing HAIs.  Read more about hospital collaboratives.
4. Measure progress towards targets for infection reduction using NHSN data as well as evaluate and share lessons learned from the C difficile collaborative.