_______________________________________________________________ Healthcare-Associated Infections
EXAMPLES OF NATIONAL INITIATIVES TO REDUCE FREQUENCY OF HEALTHCARE-ASSOCIATED INFECTIONS
Organization
Initiative(s)
Agency for Healthcare Research and Quality: Making Health Care Safer II: An Updated Critical Analysis of the Evidence for Patient Safety Practices, 2013 (22 safety practices) Institute of Medicine: Priority Areas for National Action: Transforming Health Care Quality , 2003 (20 priority areas) Institute for Healthcare Improvement: 5 Million Lives Campaign, 2006 (12 safety interventions) Surgical Care Improvement Project (partnership of several organizations), 2006 Centers for Medicaid and Medicare Services (effective October 1, 2008) U.S. Department of Health and Human Services, 2009 U.S. Department of Health and Human Services, 2011 National Quality Forum: Patient Safety, 2012 (3 broad goals) The Joint Commission, National Patient Safety Goals, 2025 (16 broad goals)
Review the evidence on patient safety practices and present priorities for their adoption
Prevent nosocomial infections and implement surveillance programs
Prevent central line-related infections Prevent surgical site infections Prevent ventilator-associated pneumonia Reduce methicillin-resistant Staphylococcus aureus (MRSA) infection Reduce postoperative complications, including surgical site infections No reimbursement for hospital costs related to catheter-associated urinary tract infections, vascular catheter-associated infections, and mediastinitis after coronary artery bypass graft surgery National Action Plan to Prevent Healthcare-associated Infections (9 targets for elimination of HAIs)
Partnership for Patients: Better Care, Lower Costs
Goal 2: Reduce the incidence of adverse healthcare-associated conditions
Prevent Infection: Follow the CDC guidelines for hand hygiene and use proven guidelines to prevent bloodstream infections from central lines, to prevent infection after surgery, and to prevent catheter-related urinary tract infections
Centers for Medicaid and Medicare Services: Partnership for Patients, 2011 (9 areas of focus) Source: [2; 7; 8; 9; 10; 11; 12; 13; 14; 15; 16]
Decrease rates of HAIs
Table 1
Government, Advocates, Clinical Leaders, and Administrators • Enhance financial incentives and regulatory oversight • Implement system-based approaches/protocols/ checklists • Achieve better use of technology • Improve public reporting of credible data • Enhance traditional and nontraditional partnerships Phase two of the HAI Action Plan focuses on ambulatory surgi- cal centers, renal dialysis facilities, and influenza vaccination of healthcare personnel. Phase three is focused on long-term care facilities, and phase four is focused on antibiotic stewardship and prevention of antibiotic resistance [2].
Phase I of the plan calls for reducing the rate of HAIs in acute care hospitals by the implementation of a collaborative 10-point strategy aimed at prevention [2]: Frontline Clinicians • Reduce inappropriate/unnecessary use of devices • Improve adherence to hand hygiene and barrier precautions • Implement and improve antimicrobial stewardship
Clinical Leaders, Executives, and Administrators • Demonstrate leadership support at the highest levels of the facility • Implement a culture of safety
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