HAI Articles

Articles

  • CDC/NHSN surveillance definition of health care–associated infection and criteria for specific types of infections in the acute care setting

    What follows are the NHSN criteria for all healthcare-associated infections (HAIs). These criteria include those for the “Big Four” (surgical site infection (SSI), pneumonia (PNEU), bloodstream infection (BSI) and urinary tract infection (UTI)), outlined in earlier chapters of this NHSN manual, as well as criteria for other types of HAIs. Of particular importance, this chapter provides further required criteria for the specific event types that constitute organ/space SSIs (e.g. mediastinitis (MED) following coronary artery bypass graft, intra-abdominal abscess (IAB) following colon surgery, etc.).

    CDC-NHSN survey def

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    National Healthcare Safety Network, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention
    2008

    Published January 17, 2013
  • Estimating health care-associated infections and deaths in U.S. hospitals, 2002 - Abstract

    OBJECTIVE: The purpose of this study was to provide a national estimate of the number of healthcare-associated infections (HAI) and deaths in United States hospitals.

    METHODS:No single source of nationally representative data on HAIs is currently available. The authors used a multi-step approach and three data sources. The main source of data was the National Nosocomial Infections Surveillance (NNIS) system, data from 1990-2002, conducted by the Centers for Disease Control and Prevention. Data from the National Hospital Discharge Survey (for 2002) and the American Hospital Association Survey (for 2000) were used to supplement NNIS data. The percentage of patients with an HAI whose death was determined to be caused or associated with the HAI from NNIS data was used to estimate the number of deaths.

    RESULTS: In 2002, the estimated number of HAIs in U.S. hospitals, adjusted to include federal facilities, was approximately 1.7 million: 33,269 HAIs among newborns in high-risk nurseries, 19,059 among newborns in well-baby nurseries, 417,946 among adults and children in ICUs, and 1,266,851 among adults and children outside of ICUs. The estimated deaths associated with HAIs in U.S. hospitals were 98,987: of these, 35,967 were for pneumonia, 30,665 for bloodstream infections, 13,088 for urinary tract infections, 8,205 for surgical site infections, and 11,062 for infections of other sites.

    CONCLUSION: HAIs in hospitals are a significant cause of morbidity and mortality in the United States. The method described for estimating the number of HAIs makes the best use of existing data at the national level.

    Written by:
    Klevens RM, Edwards JR, Richards CL Jr, Horan TC, Gaynes RP, Pollock DA, Cardo DM. Are you the author?
    Division of Healthcare Quality Promotion, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd., MS A-24, Atlanta, GA 30333, USA.

    Reference: Public Health Rep. 2007 Mar-Apr;122(2):160-6.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1820440/

     

    Published January 15, 2013
  • Guide to the elimination of catheter-associated urinary tract infections (CAUTIs)

    PURPOSE: The purpose of this document is to provide evidence-based practice guidance for the prevention of catheter-associated urinary tract Infections (CAUTI) in acute and long-term care settings.

    BACKGROUND: Health-care associated infections (HAIs) are infections acquired during the course of receiving treatment for other conditions within a health care setting. HAIs are one of the top 10 leading causes of death in the United States, according to the Centers for Disease Control and Prevention (CDC), which estimates that 1.7 million infections were reported annually among patients. It has long been acknowledged that CAUTI is the most frequent type of infection in acute care settings. In a study that provided a national estimate of health-care associated infections, urinary tract infections comprised 36% of the total HAI estimate.

    APIC-CAUTI-Guide

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    Association for Professionals in Infection Control and Epidemiology (APIC)
    2008

    Published January 17, 2013
  • Healthcare-associated infections in Pennsylvania - 2011 Report

    The 2011 report on the occurrence and patterns of health care-associated infections (HAIs) is the fourth to be released by the Pennsylvania Department of Health (PADOH) since the passage of Act 52 in 2007. The overall findings for 2011 show a continued pattern of steady decline in the incidence of HAIs in Pennsylvania. Declines were also seen in the incidence of each of the three categories of HAIs used by PADOH for hospital benchmarking. These categories are: catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), and selected types of surgical site infections (SSIs). The declining numbers are likely the result of ongoing efforts undertaken by infection preventionists, health care providers and systems, professional societies and governmental agencies to control and prevent HAIs. The impact of these efforts should be improved health status and outcomes of patients cared for in Pennsylvania hospitals, which are the primary motivation for HAI prevention and control, along with reduced health care expenditures.

    pa doh 2011 hai report

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    Pennsylvania Department of Health
    August 2012

    Published January 17, 2013
  • National Healthcare Safety Network (NHSN) report, data summary for 2009, device-associated module

    This report is a summary of device-associated module data collected by hospitals participating in the National Healthcare Safety Network (NHSN) for events occurring from January through December 2009 and reported to the Centers for Disease Control and Prevention (CDC) by October 18, 2010. This report updates previously published device-associated module data from NHSN and provides contemporary comparative rates. Procedure-associated module data will be reported separately: surgical site infection (SSI) data will be reported as standardized infection ratios utilizing new logistic regression models; post-procedure pneumonia rates for 2009 are available on the NHSN public website. This report complements other NHSN reports, including national and state-specific standardized infection ratios (SIRs) for select health-care associated infections (HAIs).

    2010NHSNReport

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    (2011) American Journal of Infection Control

    Published January 17, 2013
  • National Healthcare Safety Network (NHSN) report: data summary for 2006 through 2008, issued December 2009

    This report is a summary of device-associated (DA) and procedure-associated (PA) module data collected and reported by hospitals and ambulatory surgical centers participating in the National Healthcare Safety Network (NHSN) from January 2006 through December 2008 as reported to the Centers for Disease Control and Prevention (CDC) by July 6, 2009. This report updates previously published DA and PA module data from the NHSN.

    2009NHSNReport

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    (2009) American Journal of Infection Control

    Published January 17, 2013
  • Reduction in catheter-associated urinary tract infections by bundling interventions - Abstract

    OBJECTIVE:Urinary tract infections (UTIs) are the most common type of hospital-acquired infection, and most are associated with indwelling urinary catheters, that is, catheter-associated UTIs (CAUTIs). Our goal was to reduce the CAUTI rate.

    DESIGN/SETTING/INTERVENTIONS:We retrospectively examined the feasibility and cost-effectiveness of a bundle of four evidence-based interventions upon the incidence rate (IR) of CAUTIs in a community hospital. The first intervention was the exclusive use of silver alloy catheters in the hospital's acute care areas. The second intervention was a securing device to limit the movement of the catheter after insertion. The third intervention was repositioning of the catheter tubing if it was found to be touching the floor. The fourth intervention was removal of the indwelling urinary catheter on postoperative Day 1 or 2, for most surgical patients.

    MAIN OUTCOME MEASURE:Rates of CAUTI per 1000 catheter days were estimated and compared using the generalized estimating equations Poisson regression analysis.

    RESULTS: During the study period, 33 of the 2228 patients were diagnosed with a CAUTI. The CAUTI IR for the pre-intervention period was 5.2/1000. For the 7 months following the implementation of the fourth intervention, the IR was 1.5/1000 catheter days, a significant reduction relative to the pre-intervention period (P = 0.03). The annualized projection for the cost of implementing this bundle of four interventions is $23,924.

    CONCLUSION:A bundle of four evidence-based interventions reduced the incidence of CAUTIs in a community hospital. It is relatively simple, appears to be cost-effective and might be sustainable and adaptable by other hospitals.

    Written by:
    Clarke K, Tong D, Pan Y, Easley KA, Norrick B, Ko C, Wang A, Razavi B, Stein J. Are you the author?
    Division of Hospital Medicine, Department of Medicine, Emory University School of Medicine, 1365 Clifton Road, Suite A4326, Atlanta, GA 30322,, USA.

    Reference: Int J Qual Health Care. 2012 Dec 6.

    http://intqhc.oxfordjournals.org/content/early/2012/12/05/intqhc.mzs077.abstract

     

     

    Published January 17, 2013
  • The direct medical costs of healthcare-associated infections in U.S. hospitals and the benefits of prevention

    This report uses results from the published medical and economic literature to provide a range of estimates for the annual direct hospital cost of treating health-care associated infections (HAIs) in the United States. Applying two different Consumer Price Index (CPI) adjustments to account for the rate of inflation in hospital resource prices, the overall annual direct medical costs of HAI to U.S. hospitals ranges from $28.4 to $33.8 billion (after adjusting to 2007 dollars using the CPI for all urban consumers) and $35.7 billion to $45 billion (after adjusting to 2007 dollars using the CPI for inpatient hospital services). After adjusting for the range of effectiveness of possible infection control interventions, the benefits of prevention range from a low of $5.7 to $6.8 billion (20% of infections preventable, CPI for all urban consumers) to a high of $25.0 to $31.5 billion (70% of infections preventable, CPI for inpatient hospital services).

    scott costpaper

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    Scott, D. R. II. (2009). "Economist." Centers for Disease Control and Prevention. 

    Published January 17, 2013
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