Hospitals reduced significantly the number of surgical site and central-line associated bloodstream infections in 2013, according to a national analysis by the Centers for Disease Control and Prevention.
A review of data submitted by 14,500 health facilities found that central line–associated bloodstream infections (CLABSIs) fell by 46% between 2008 and 2013, and surgical site infections (SSIs) dropped by 19% over the same period. SSI data were derived from 10 select procedures, including hip arthroplasty, knee arthroplasty, colon surgery, rectal surgery, abdominal hysterectomy, vaginal hysterectomy, coronary artery bypass graft, other cardiac surgery, peripheral vascular bypass surgery, and abdominal aortic aneurysm repair.
Increased reporting by health care providers and quality measures imposed by the Centers for Medicare and Medicaid Services are likely contributors to the report’s findings, said Dr. Henry Pitt, chief quality officer for Temple University Health System, Philadelphia.
“Because of all the reporting that is being done, and the potential financial burdens that exist through CMS’s value-based purchasing program, and the work people are doing to improve these things, it’s not surprising that the data are looking better,” Dr. Pitt said in an interview.
The CDC’s annual National and State Healthcare-associated Infection Progress report summarizes data submitted to the CDC’s National Healthcare Safety Network (NHSN), a nationwide infection tracking system used by all 50 states, Washington, and Puerto Rico. In addition to SSIs and CLABSIs, findings of the report show also that methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections decreased by 8% from 2011 to 2013 and that Clostridium difficile infections dropped by 10% between 2011 and 2013. However, catheter-associated urinary tract infections have risen by 6% since 2009.
In a state-by-state comparison, 26 states performed better than the nation on at least two of the six infection types tracked by state. Sixteen states performed better than the nation on three or more infections and 19 states performed worse than the nation on two infections. Not all states reported or had enough data to calculate valid infection information on every infection in the report. Among the 2,543 U.S. hospitals with enough data to calculate a standardized infection ratio (SIR), 9% had an SIR significantly worse than the national SIR of 0.81.
Despite the progress, the report calls for more action to eliminate hospital infections and recommends its report be used by health departments, hospital associations, professional societies, health care systems and facilities, and quality improvement groups to identify infections that need additional prevention efforts.
Dr. Pitt added that CMS programs that use infection control and reduction as quality metrics will no doubt continue to impact infection reporting and outcomes. The three CMS programs associated with infection control and hospital payments include its hospital value-based purchasing, hospital readmissions reduction, and hospital-acquired condition reduction programs.
“Again, people are paying more attention, in addition to it’s the right thing to do, because more money is at risk,” Dr. Pitt said.
Data in the CDC report are from acute hospitals only.
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