The Department of Health and Human Services (HHS), the Association for Professionals in Infection Control and Epidemiology (APIC), and the Society for Healthcare Epidemiology of America (SHEA) today recognized the University of Wisconsin Hospital and Clinics (UWHC) with the 2013 Partnership in Prevention Award for achieving sustainable improvements toward eliminating healthcare-associated infections (HAIs).
Co-sponsored by HHS, APIC, and SHEA, this annual award is based on the concepts of the “National Action Plan to Prevent Health Care-Associated Infections: Roadmap to Elimination.”
At any given time, about 1 in every 20 inpatients has an infection related to hospital care. These infections cost the U.S. healthcare system billions of dollars each year and lead to the loss of tens of thousands of lives.
Preventing HAIs requires a multidisciplinary approach, implemented by a team that includes hospital administrators, healthcare providers, clinical leaders, infection prevention experts, and others throughout the care setting. The University of Wisconsin Hospital and Clinics, a 566-bed tertiary care facility, engaged multidisciplinary collaborative teams, bolstered by effective and engaged leadership, to successfully implement a number of innovative interventions to prevent HAIs. Through this comprehensive approach, UWHC was able to significantly reduce ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infections (CAUTI), which are two of the most common HAIs.
“HAI prevention is an essential element of improving patient care. The 2013 Partnership in Prevention applicants demonstrated that the best patient outcomes are achieved when prevention involves multidisciplinary teams with leadership support working together,” says John Jernigan, MD, MS, president of SHEA. “Focusing efforts on using evidence-based approaches, standardizing work flow, and ensuring the patient-care teams are informed and involved is the most effective way to eliminate HAIs.”
“The multidisciplinary approaches, passion, and innovation of the 2013 Partnership in Prevention Award applicants, and the excellent programs they described, demonstrate that significant progress is being made in eliminating HAIs to protect patients,” says Patti Grant, RN, BSN, MS, CIC, APIC president. “Throughout the coming year, APIC is focusing attention on the important role that patients and families also play through our Infection Prevention and You campaign. We hope this focused attention will drive further adherence to, and support for, evidence-based interventions to prevent healthcare-associated infections.”
Utilizing the Systems Engineering Initiative for Patient Safety (SEIPS), UWHC reduced the hospital-wide CAUTI rate from 4.7 per 1,000 catheter-days in 2011, to 3.5 per 1,000 catheter-days in 2012. The SEIPS model ensures patient safety by taking into consideration human factors, systems design, quality management, job design, and technology implementations. The team used a multi-faceted approach including daily rounds on patients with indwelling catheters, catheter removal protocols embedded in the electronic health record, CAUTI “champions” on each unit, and a CAUTI tool box on the hospital’s intranet site.
The hospital undertook a similar initiative to reduce VAP in their 24-bed neuroscience intensive care unit (ICU). By reinforcing best practices for VAP prevention, they only had two such infections between November 2011 and June 2013. Prior to the intervention, from January to October of 2011, there were 15 VAPs. They have since extended the effort to their medical-surgical ICU and have seen similar reductions.
UWHC also made hand hygiene a priority through adoption of the World Health Organization’s hand hygiene campaign: Five Moments for Hand Hygiene. Since 2012, their hand hygiene compliance rates have improved from 46 to 90 percent, and they continue to rise. As part of their effort, they developed training videos, rewards and incentives, and standardized hand hygiene observation forms.