At least 12 Indiana Hospitals Report Having No Central Line Infections

In early February 2012, CMS made hospital central line associated blood stream infection (CLABSI) data available on its HospitalCompare website.

Of the 125 Indiana hospitals listed in HospitalCompare, 88 were eligible for CLABSI reporting. For various reasons (small n, no ICU in hospital, etc...), no rating was provided for 65 hospitals. Of the remaining 22 hospitals, 12 reported no infections.

The 12 Indiana hospitals are:

Hospital	City
ELKHART GENERAL HOSPITAL	ELKHART
WILLIAM N WISHARD MEMORIAL HOSPITAL	INDIANAPOLIS
FRANCISCAN ST FRANCIS HEALTH - BEECH GROVE	BEECH GROVE
PORTER VALPARAISO HOSPITAL	VALPARAISO
FLOYD MEMORIAL HOSPITAL AND HEALTH SERVICES	NEW ALBANY
REID HOSPITAL & HEALTH CARE SERVICES	RICHMOND
COMMUNITY HOSPITAL EAST	INDIANAPOLIS
DEACONESS HOSPITAL INC	EVANSVILLE
INDIANA UNIVERSITY HEALTH BALL MEMORIAL HOSPITAL	MUNCIE
COMMUNITY HOSPITAL	MUNSTER
ST VINCENT HEART CENTER OF INDIANA LLC	INDIANAPOLIS

CMS published this data based on 1Q2011 only. This measure is based on the CDC's NHSN data collection protocol.

CDC Updates CA-UTI Prevention Guidelines

Last week the CDC released its updated CA-UTI Prevention Guidelines - last published in 1981.

The guidelines can be found here.

The following is an excerpt from the document's executive summary with sections of interest in red:

This guideline updates and expands the original Centers for Disease Control and Prevention (CDC) Guideline for Prevention of Catheter-associated Urinary Tract Infections (CAUTI) published in 1981. Several developments necessitated revision of the 1981 guideline, including new research and technological advancements for preventing CAUTI, increasing need to address patients in non-acute care settings and patients requiring long-term urinary catheterization, and greater emphasis on prevention initiatives as well as better defined goals and metrics for outcomes and process measures. In addition to updating the previous guideline, this revised guideline reviews the available evidence on CAUTI prevention for patients requiring chronic indwelling catheters and individuals who can be managed with alternative methods of urinary drainage (e.g., intermittent catheterization). The revised guideline also includes specific recommendations for implementation, performance measurement, and surveillance. Although the general principles of CAUTI prevention have not changed from the previous version, the revised guideline provides clarification and more specific guidance based on a defined, systematic review of the literature through July 2007. For areas where knowledge gaps exist, recommendations for further research are listed. Finally, the revised guideline outlines high-priority recommendations for CAUTI prevention in order to offer guidance for implementation.

This document is intended for use by infection prevention staff, healthcare epidemiologists, healthcare
administrators, nurses, other healthcare providers, and persons responsible for developing, implementing, and evaluating infection prevention and control programs for healthcare settings across the continuum of care. The guideline can also be used as a resource for societies or organizations that wish to develop more detailed implementation guidance for prevention of CAUTI.

Our goal was to develop a guideline based on a targeted systematic review of the best available evidence, with explicit links between the evidence and recommendations. To accomplish this, we used an adapted GRADE system approach for evaluating quality of evidence and determining strength of recommendations. The methodology, structure, and components of this guideline are approved by HICPAC and will be used for subsequent guidelines issued by HICPAC. A more detailed description of our approach is available in the Methods section.

AHRQ Tools and Resources to Prevent HAIs.

In early September, the AHRQ released a webpage highlighting research and resources related to the prevention of hospital acquired infections. This is an excellent site that links to tools and resources for both healthcare providers as well as healthcare consumers.

You can find the website here.

APIC Study Finds Hospitals Are Cutting Back on Infection Prevention???

The Association for Professionals in Infection Control and Epidemiology issued a press release on June 9th reporting its findings that hospitals are cutting back on the infection control/prevention function across the country.

You can download the press release here.

Excerpts:

The “2009 APIC Economic Survey” found that of nearly 2,000 infection preventionists who responded, 41 percent reported reductions in budgets for infection prevention in the last 18 months due primarily to the economic downturn.

According to the survey, three-quarters of those whose budgets were cut experienced decreases for the necessary education that trains healthcare personnel in preventing the transmission of healthcare-associated infections (HAIs) such as MRSA and C. difficile. Half saw reductions in overall budgets for infection prevention, including money for technology, staff, education, products, equipment and updated resources. Nearly 40 percent had layoffs or reduced hours, and a third experienced hiring freezes.

“Infection prevention departments at our nation’s healthcare facilities are severely understaffed and under-resourced,” said APIC CEO Kathy L. Warye. “Without enough trained professionals, funding and high-tech solutions that speed access to infection-related data, we are not going to continue to make progress in eliminating preventable infections. While cuts in staff, training and technology may ease budgets in the shortterm, the effect of increased infections will erode the bottom line over time, not to mention cause needless pain, suffering and death.”

Carbapenem-Resistant Enterobacteriaceae

The IHI today posted CDC guidelines regarding Carbapenem-Resistant Enterobacteriaceae (CRE) on its website.

You can find IHI post here.
You an go directly to the CDC guidelines here.

Excerpt of IHI posting:

Infection with carbapenem-resistant Enterobacteriaceae (CRE) or carbapenemase-producing enterobacteriaceae is emerging as an important challenge in health care settings. This threatens to become a problem akin to MRSA. Institutions must be alert for this and other very resistant organisms (ESBL, CTX producing gram negatives, etc.) and not limit foci to C. difficile and MRSA.