Special Edition on Infection Prevention & Control | Page 12

cover story
HAI Prevention
Progress: Small
Decreases Indicate
Room for Improvement,
Continued Vigilance
By Kelly M. Pyrek
The National and State Healthcare-Associated Infections
Progress Report is our community’s report card on how the
country is making progress on HAI prevention and control in
healthcare institutions, with targets established in the National
Action Plan to Prevent Health Care-Associated Infections: Road
Map to Elimination (HAI Action Plan). The most recent data
available, from 2018, indicate that the needle is moving more
slowly for the HAIs that are reportable to the National Healthcare
Safety Network (NHSN), including central line-associated
bloodstream infections (CLABSIs), catheter-associated urinary
tract infections (CAUTIs), ventilator-associated events (VAEs),
surgical site infections (SSIs), methicillin-resistant Staphylococcus
aureus (MRSA) bloodstream events, and Clostridioides difficile
(C. difficile) events, formerly known as Clostridium difficile.
Nationally, among acute-care hospitals (ACHs), the 2018
report finds:
●Overall, about 9 percent decrease in CLABSI between 2017
and 2018, with the largest decrease in the ICU (11 percent)
●Overall, about 8 percent decrease in CAUTI between
2017 and 2018
●Largest decrease in ICU (10 percent)
●Overall, there was no significant change in VAE between
2017 and 2018
●Overall, there was no significant change in SSI related to
the 10 select procedures tracked in the report between 2017
and 2018, including no significant changes in abdominal hysterectomy
SSIs and no significant changes in colon surgery SSIs
●No significant changes in hospital onset MRSA bacteremia
between 2017 and 2018
●About 12 percent decrease in hospital-onset C. difficile
infections between 2017 and 2018
Q A &Moving the Needle on HAIs:
A Q&A With 2020 APIC President
Connie Steed, MSN, RN, CIC, FAPIC
HHM What are the challenges that persist when
it comes to making real strides in preventing HAIs?
Connie Steed (CM): An imperative for any healthcare
organization (HCO) seeking to become a high-reliability
organization is sustaining process improvements regardless
of staff turnover. To achieve and maintain an effective
infection prevention and control program, leaders must
hold healthcare providers accountable “for following
the rules,” including infection prevention basics such as
hand hygiene, device related care bundles, proper use of
personal protective equipment, cleaning and disinfection
of equipment and the environment.
The underlying health of our patients is a variable that
we as healthcare providers can’t completely control. HCOs
need to focus on population health across the continuum to
promote good health and prevent major health issues such
as morbid obesity and diabetes that increase infection risk.
HHM What interventions work best to start
moving the needle on HAIs that have shown little
to no progress?
CS: The CDC, AHRQ, IHI, APIC, SHEA, and other
organizations provide guidance for care and methods to
conduct process improvement (PI) initiatives (e.g., PDSA
or plan, do, study, act). For these efforts to succeed,
infection preventionists (IPs) need to lead as subject matter
experts with support and guidance from an empowered,
multidisciplinary team. What is also critical is buy-in and
support for infection prevention from the C-suite. IPs cannot
do this alone; success depends on the engagement of a
strong team that includes support from the top.
Sustaining improvements is hard work. In my experience,
the number one mistake HCOs make is they monitor
improvements for three to six months and then they stop.
Monitoring process changes must be an ongoing strategy.
• Hand hygiene compliance continues to be a challenge.
During the past decade, there has been increasing
12 IP&C Special Edition June 2020 • www.healthcarehygienemagazine.com