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Multicenter Study
. 2012 Jul;27(7):773-9.
doi: 10.1007/s11606-011-1935-y. Epub 2011 Dec 6.

Preventing hospital-acquired infections: a national survey of practices reported by U.S. hospitals in 2005 and 2009

Sarah L Krein  1 , Christine P Kowalski, Timothy P Hofer, Sanjay Saint
Affiliations
Multicenter Study

Preventing hospital-acquired infections: a national survey of practices reported by U.S. hospitals in 2005 and 2009

Sarah L Krein et al. J Gen Intern Med. 2012 Jul.

Abstract

Background: Hospital-acquired infection (HAI) is common, costly, and potentially lethal. Whether initiatives to reduce HAI--such as the Centers for Medicare and Medicaid Services (CMS) no payment rule--have increased the use of preventive practices is not known.

Objective: To examine the use of infection prevention practices by U.S. hospitals and trends in use between 2005 and 2009.

Design, setting, and participants: Surveys of infection preventionists at non-federal general medical/surgical hospitals and Department of Veterans Affairs (VA) hospitals, which are not subject to the CMS no payment rule, in 2005 and 2009.

Main measures: Percent of hospitals using practices to prevent central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI).

Key results: Survey response was approximately 70%. More than 1/2 of non-federal hospitals reported a moderate or large increase in CLABSI, VAP and CAUTI prevention as a facility priority due to the non-payment rule; over 60% of VA hospitals reported no change in priority. However, both non-federal and VA hospitals reported significant increases in use of most practices to prevent CLABSI, VAP and CAUTI from 2005 to 2009, with 90% or more using certain practices to prevent CLABSI and VAP in 2009. In contrast, only one CAUTI prevention practice was used by at least 50% of hospitals.

Conclusions: Since 2005, use of key practices to prevent CLABSI, VAP and CAUTI has increased in non-federal and VA hospitals, suggesting that despite its perceived importance, the non-payment rule may not be the primary driver. Moreover, while 65% of non-federal hospitals reported a moderate or large increase in preventing CAUTI as a facility priority, prevention practice use remains low.

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Figures

Figure 1
Figure 1
Use of Practices to Prevent Central Line-Associated Bloodstream Infection (CLABSI) in 2005 and 2009.
Figure 2
Figure 2
Use of Practices to Prevent Ventilator-Associated Pneumonia (VAP) in 2005 and 2009.
Figure 3
Figure 3
Use of Practices to Prevent Catheter-Associated Urinary Tract Infection (CAUTI) in 2005 and 2009.
See this image and copyright information in PMC

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