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Infection Control
Infection Prevention and Control in the US—Current Status
a report by
Sue Sebazco, RN, BS, CIC
Infection Prevention/Employee Health Director, Arlington Memorial Hospital
The standard is set. Patient safety is number one. The goal is established: develop the standards. Funding was obtained, a Steering Committee and
zero tolerance for preventable adverse outcomes in healthcare facilities in six Technical Advisory Panels were appointed, and the report is due to the
the US. This includes healthcare-associated infections (HAIs). The infection NQF board for consideration in late September 2007. APIC, the Infectious
prevention and control community welcomes the focus on HAIs among US Diseases Society of America (IDSA), and SHEA wrote model legislation of
healthcare users. The result of this area of interest, and the effectiveness of public reporting of HAIs to provide a template for state legislatures
infection prevention and control programs, now has the attention of considering patient safety initiatives. This model was designed to provide
administrators who allocate resources in US healthcare organizations. direction for states to develop systems that are “based on reliable data,
adhere to recommended practices that have been shown to reduce the
Transparency is an expectation not only of the consumer, but also of risk of healthcare-associated infections and improve patient care, protect
healthcare organizations. Organizations strive for excellence and, through confidentiality of medical records and reflect the fact that some
teamwork and a passion to achieve performance improvement, goals institutions treat more seriously ill patients.”
5
The Healthcare-Associated
once thought unachievable are being realized. The movement is fast- Infection Working Group of the Joint Public Policy Committee—SHEA,
paced, surrounded by a sense of urgency. There is now evidence that APIC, the Council of State and Territorial Epidemiologists (CSTE), and
certain HAIs can be prevented and the favorable performance sustained CDC—wrote a toolkit entitled ‘Essentials of Public Reporting of
over time.
1
Healthcare-Associated Infections: A Tool Kit’ to give states and healthcare
facilities facing legislative mandates practical management strategies for
implementing them.
4,5
There is now evidence that certain
A major consideration surrounding mandatory reporting is identifying the
healthcare-associated infections can
appropriate available data to use for public reporting. The APIC Research
Council funded a project that attempted to answer this question. The
be prevented and the favorable
project study looked at which data are most reflective of quality and HAIs in
performance sustained over time.
public reporting. The results are currently being prepared for publication.
4
At the time of writing, 36 states have mandatory reporting of HAIs or study
bills in place, or have some activity relating to mandatory reporting.
4
It was recognized early on in the infection prevention and control
community, as this focus on HAIs emerged, that we, the infection Another major challenge facing healthcare organizations in the US is the
prevention professionals, needed to define the course. In early 2004, it presence of multidrug-resistant organisms (MDROs) across the continuum of
became evident that the consumer movement calling for mandatory care delivery systems. MDROs are introduced as a potential reservoir into the
public reporting of HAIs was gaining momentum. Federal agencies, healthcare facility at the time of admission in one of two ways: active
professional associations and societies, and state legislatures responded. infection or colonization. Standard precautions are designed to protect
At the Centers for Disease Control and Prevention (CDC), the Healthcare individuals at all times in the healthcare setting from unrecognized
Infection Control Practices Advisory Committee (HICPAC) recognized the pathogens through the consistent application of appropriate hand hygiene
urgency of developing a position on this initiative. ‘Guidance on Public and barriers. However, even though this intervention is in place within
Reporting of Healthcare-Associated Infections’ was drafted in record time
and published in February 2005 in the American Journal of Infection
Sue Sebazco, RN, BS, CIC, is the Infection Prevention/Employee
Control.
8
The Association for Professionals in Infection Control and
Health Director at Arlington Memorial Hospital in Arlington,
Epidemiology, Inc. (APIC) convened a conference co-sponsored by the Texas. She was the 2005 President of the Association for
CDC and the Society of Healthcare Epidemiologists of America (SHEA).
Professionals in Infection Control and Epidemiology, Inc. (APIC),
and is Chair of APIC’s Public Policy Committee. She is a former
This conference on mandatory reporting resulted in the recognition that
recipient of the Gerry Haynes Memorial Award for Excellence in
national standards for reporting HAIs were needed to provide the public Infection Control.
with meaningful and accurate comparative data among healthcare
providers. The National Quality Forum (NQF) had a model in place to
© T OUCH BRIEFINGS 2007
59
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