Nationwide Survey Findings Underscore Challenges, Identify Actions in Addressing HAIs

CHARLOTTE, N.C. -- Hospital professionals identified tracking infections across the entire hospital, and the control of resistant organisms, as their top challenges related to managing healthcare-associated infections (HAIs), according to a survey of more than 800 hospital clinicians involved in infection prevention.

Survey respondents, which include quality, safety, risk management and infection control professionals representing all sizes of hospitals, also identified measuring compliance with hand hygiene and state mandated public reporting as major challenges.

Respondents cited catheter-associated urinary tract infections (49 percent) and pressure ulcers (30 percent) as the most challenging to prevent among infections identified by the Centers for Medicare and Medicaid Services (CMS) for non-payment in 2008. Under current payment rules, CMS typically pays hospitals more for treating a patient who develops an infection. CMS announced that, beginning Oct. 1, 2008, it will no longer reimburse hospitals for treating certain preventable conditions, including errors, injuries and infections that occur in hospitals.

This is an important assessment of what infection control and quality experts see as their greatest clinical challenges in managing hospital-acquired conditions, said Premier Safety Institute vice president Gina Pugliese. The Premier healthcare alliance will be using this information to continue working with experts in hospitals on steps and best practices to address all causes of infection.

The survey also found inadequate staffing for infection prevention (47 percent) and funding and budget constraints (34 percent) to be the most significant issues their hospitals face in meeting current infection prevention challenges.

This finding underscores that healthcare professionals are dealing with a variety of competing demands in working to prevent healthcare-associated infections, said Blair Childs, Premiers senior vice president of public affairs. To date, 26 states have public reporting requirements that are placing new demands on hospitals, the new present on admission coding system mandated by CMS needs to be implemented, and there are new reporting requirements from government and accreditation organizations. These demands are complicating what is already a significant task of monitoring and preventing HAIs.

Hospitals are clearly turning to technology as a way to manage these demands. More than 22 percent of respondents currently utilize an automated surveillance system, up from 13 percent in February. An additional 47 percent of respondents are actively considering implementing this technology, shown to make surveillance more efficient and to free up time for prevention activities.

More and more hospitals are starting to use automated surveillance systems to accomplish timely and efficient tracking of HAIs across the entire patient population, said Dan Peterson, MD, MPH, medical advisor for Premier. Such systems are also key to meeting the ever increasing regulatory, reporting, and accreditation requirements around infection prevention.

Respondent quotes:

Collecting data and reporting HAIs for public reporting takes the time of infection control professionals who should be working on prevention for the majority of their time.

Once again, legislation has taken nurses further away from actual patient care and safety.

We recognize that public reporting may increase surveillance time but could decrease the ability of infection control staff to focus on prevention measures unless additional full time employee support is provided.

Focus of the infection control program should be on prevention and not just counting infections.

Source: Premier Inc.