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

J Gen Intern Med. 2012 Jul;27(7):773-9. doi: 10.1007/s11606-011-1935-y. Epub 2011 Dec 6.


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.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Catheter-Related Infections / prevention & control
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / instrumentation
  • Cross Infection / prevention & control*
  • Health Care Surveys
  • Humans
  • Infection Control / methods*
  • Infection Control / trends
  • Longitudinal Studies
  • Pneumonia, Ventilator-Associated / prevention & control
  • Professional Practice / statistics & numerical data*
  • United States
  • Urinary Tract Infections / prevention & control
  • Urinary Tract Infections / transmission