Survey of Infection Preventionists Indicates Need for Increase in Physician Leadership in Preventing HAIs

ARLINGTON, Va. – An increase in executive and physician leadership and improvements in general infection prevention practices are needed to help prevent healthcare-associated infections (HAIs) and improve patient care, according to a survey of more than 930 infection preventionists nationwide.

Only 15 percent of survey respondents indicated that executive and physician leadership are actively engaged and leading the charge against infections in their facilities, though 30.3 percent suggested executives and physicians are the most important resource to meet HAI challenges. When asked how HAI data are shared between infection preventionists and executives, 57.6 percent of respondents cited regular agenda discussions at Board meetings, but only 15.3 percent responded that senior leadership provides feedback and recommendations.

“The effect of HAIs annually on U.S. hospitals is staggering: Two million patients infected; 90,000 deaths, more than one death every six minutes; excess costs of nearly $6 billion,” said APIC’s CEO Kathy Warye. “Healthcare leaders must make infection prevention a priority and allocate resources to efforts that target institution-wide prevention, education, measurement and process improvements.”

Survey respondents, which included quality, safety, risk management and infection preventionists representing all types and sizes of hospitals, cited removing unnecessary indwelling urinary catheters (55.5 percent), a practice that prevents urinary tract infections (UTIs), as the most challenging HAI prevention intervention to implement. Measuring compliance with hand hygiene practices recommended by the Centers for Disease Control and Prevention (CDC) was also identified by 35.5 percent of the respondents as a significant challenge.

“Improving compliance with infection prevention practices requires integration of these practices into the daily tasks of all clinicians,” said Premier Safety Institute vice president Gina Pugliese, RN, MS. “This necessitates a redesign of our systems and processes, such as the use of checklists for critical tasks or strategically placed alcohol-based hand rub dispensers.”

In October 2008, changes to the Centers for Medicare & Medicaid Services (CMS)’s Inpatient Prospective Payment System (IPPS) will take effect, potentially reducing reimbursement for certain hospital-acquired conditions (HACs), including HAIs. In order to optimize organization readiness for this change, respondents cited accurate and/or appropriate physician documentation of patient records (51.6 percent) and accurate coding, including accurate use of new present on admission (POA) codes (20.2 percent), as the activities needing the most attention.

“The accurate identification and coding of HAIs is going to be challenging without collaboration across multiple areas of the hospital,” said Daniel Varga, MD, chief medical officer at SSM Health Care. “Executive leadership needs to work with doctors, nurses, and infection prevention and control staff to ensure that these teams drive system design and culture change.”

Source: Premier Inc.