Epidemiologists, Infection Preventionists Share Common Goal of Fighting HAIs

I welcome the opportunity to introduce the readers of Infection Control Today to the Society for Healthcare Epidemiology of America (SHEA) and update them on recent activities. For more than 20 years, SHEA and its members have focused on advancing the science of infection prevention and healthcare epidemiology. Through clinical guideline development, education, and advocacy efforts, SHEA is known for its leadership in science and research in epidemiology and infection prevention. SHEA is a leading partner in an ever-growing panoply of organizations devoted to quality improvement, patient safety, and infection control. Our role continues to be found in providing a rational voice based on science and its application to practice.

Healthcare epidemiologists, infection preventionists and others in North America and abroad are facing the challenges of increasingly virulent pathogens, vulnerable patient populations, and complex regulatory and cost containment realities. SHEA’s focus is on providing a forum for those working in the field and to support the implementation of best practices. Through its journal, Infection Control and Hospital Epidemiology (ICHE), the work of its committees, and its educational conferences and courses, SHEA has cultivated sound and measured recommendations to infection prevention and control teams worldwide, as well as to legislators, administrators, and other interested parties. SHEA’s activities hinge on providing practical, evidence-based strategies to help healthcare professionals meet today’s challenges.

This fall, SHEA joined the Infectious Diseases Society of America (IDSA), the Association of Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and the Joint Commission in releasing the much anticipated SHEA/IDSA Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute-Care Hospitals. As was noted this year in a report by the Government Accountability Office (GAO), the numerous recommendations in infection prevention and control present real challenges to those seeking concise advice on how to best combat healthcare-associated infections (HAIs). This document, supported by 29 organizations in the field, synthesizes the many existing guidelines to provide a practical tool for hospitals to use to prevent six common HAIs. The compendium is available in an open access format at: http://www.shea-online.org/index.cfm as well as at the Web sites of the IDSA, Joint Commission, and other sponsoring organizations.

Of the six HAIs covered in the Compendium, four are device and procedure related – surgical site infections (SSI), central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and ventilator-associated pneumonia (VAP), and two are organism specific – Clostridium difficile and methicillin-resistant Staphylococcus aureus (MRSA). The document is organized into minimum basic practices that should be adopted by all acute-care hospitals, and special approaches, for use in locations or populations within hospitals when infections are not controlled using the basic practices.

Coinciding with the release of the Compendium, SHEA, with the CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC), published a position paper addressing the escalating rates of multi drug-resistant organisms (MDROs) and key ways to track these problematic pathogens. SHEA and HICPAC have underlined the need for healthcare providers to be able to effectively measure the resistance patterns in their facilities to guide intervention efforts. This document provides an important link to the advanced strategies outlined in the Compendium by assisting infection prevention teams with methods to develop an accurate picture of their institutional MDRO landscape and means to monitor progress of intervention efforts.

Public interest in the challenges facing healthcare epidemiologists and infection preventionists continues to swell, as evidenced by a growing number of campaigns to eliminate HAIs, public reporting statutes, and coverage in the popular media. The call for greater transparency, combined with growing regulatory scrutiny and a desire to increase accountability by tying performance to reimbursement creates an imperative for everyone in the hospital to understand the basic epidemiology of infectious diseases. Likewise, it puts forth a mandate for SHEA and allied organizations to promote clear prevention and control strategies supported by scientific evidence.

As we proceed in our mission to promote the science of infection prevention, we appreciate the viewpoint of the public and our legislative officials. Our goal is to not only put in the hands of healthcare providers best practices, but also to educate our legislators and assist in crafting scientifically sound policies. The role of unintended consequences in legislating healthcare practices and unfunded mandates is of primary concern. Unfortunately, the reality is that healthcare professionals live in a world of scarce resources and need to prioritize preventive efforts. As such, through our policy activities and position papers, we have taken the role of communicating the risks to patients of diverting resources from comprehensive infection prevention programs.

Over the next three months, SHEA will be preparing for its 19th annual scientific meeting, to be held in San Diego March 19-22. I hope to see many of you at what promises to be a very stimulating and cutting-edge conference. To open the meeting, we will examine the question of what is in store for the future of our discipline. Other sessions will address the challenges of antimicrobial resistance and legislation on the state and federal stage.

Collectively, we have the expertise and the responsibility to make best practices the standard for front line healthcare workers while increasingly serving as advocates for our profession and for the safety of our patients. We must continue to devote our energy toward educating professionals working at all levels of infection prevention and healthcare epidemiology and expanding the scientific knowledge base of our field.

Mark E. Rupp, MD, is president of the Society for Healthcare Epidemiology of America (SHEA), professor at the University of Nebraska Medical Center, and director of the Department of Healthcare Epidemiology.