Healthcare-associated infections down in first state-by-state report
CDC: Infection rates drop, but progress still unclear
THE WEEK IN HEALTHCARE
New figures from Centers for Disease Control and Prevention suggest hospitals are gaining significant ground in their efforts to lower the rates of healthcare-associated infections. According to the CDC’s first state-specific report on HAIs, released May 27, the number of central line-associated bloodstream infections dropped 18% during the first six months of 2009 when compared with rates from the three previous years.
The CDC arrived at that number using data from its National Healthcare Safety Network, a surveillance and prevention program that uses hospital-reported data to track rates of HAIs across the country. Among the 1,538 hospitals that reported infection data to the NHSN during the first half of 2009, there were 4,615 observed central line-associated blood- stream infections compared with the nearly 5,619 predicted for that time period.
The findings are encouraging and emphasize the importance of current improvement initiatives, said Arjun Srinivasan, associate director for healthcare-associated infection prevention programs at the CDC’s Division of Healthcare Quality Promotion. But the real test of progress will come with future NHSN reports, which will be released every six months, he added.
In addition to providing overall rates of central line infections for the country, the CDC was also able to assess the individual performance of the 17 states that mandate NHSN reporting for all of their hospitals. Using data reported during previous years, the agency assigned each of the states a standardized infection ratio, which compares the actual number of infections with baseline national numbers.
For instance, Oklahoma’s 48 reporting facilities observed 59 central line-associated bloodstream infections, 50% less than the predicted number of 119, for a standardized infection ratio of 0.50 (actual infections compared with expected infections). Eleven of the 17 states had standardized infection ratios that were significantly less than 1.0, meaning they had lower infection rates than expected based on the national average.
The data from the CDC report is particularly meaningful, experts say, because the safety network uses standardized HAI definitions and data-collection methods that are governed by rigorous protocols. Several recent reports on healthcare-associated infections, including the Agency for Healthcare Research and Quality’s National Healthcare Quality Report, released in April, have relied on administrative coding and billing data to draw their conclusions, (April 26, p. 7).
By contrast, the NHSN was designed expressly for the purpose of monitoring HAIs, and requires specialized staff and adherence to guidelines, said Neil Fishman, president of the Society for Healthcare Epidemiology of America and director of the department of healthcare epidemiology and infection control for the University of Pennsylvania Health Sys-
Srinivasan finds the decrease in infections promising.