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Survey Cites Executive and Physician Leadership, Adherence to Infection Prevention Practices As Areas of Improvement to Prevent Healthcare-Associated Infections, Improve Patient Care

Posted on: Tuesday, 23 September 2008, 12:00 CDT

An increase in executive and physician leadership and improvements in general infection prevention practices are needed to help prevent healthcare-associated infections (HAIs) and improve patient care, according to a survey of over 930 infection preventionists nationwide.

Only 15 percent of survey respondents indicated that executive and physician leadership are actively engaged and leading the charge against infections in their facilities, though 30.3 percent suggested executives and physicians are the most important resource to meet HAI challenges. When asked how HAI data are shared between infection preventionists and executives, 57.6 percent of respondents cited regular agenda discussions at Board meetings, but only 15.3 percent responded that senior leadership provides feedback and recommendations.

"The effect of HAIs annually on U.S. hospitals is staggering: Two million patients infected; 90,000 deaths, more than one death every six minutes; excess costs of nearly $6 billion," said APIC CEO Kathy Warye. "Healthcare leaders must make infection prevention a priority and allocate resources to efforts that target institution-wide prevention, education, measurement and process improvements."

Survey respondents, which included quality, safety, risk management and infection preventionists representing all types and sizes of hospitals, cited removing unnecessary indwelling urinary catheters (55.5 percent), a practice that prevents urinary tract infections (UTIs), as the most challenging HAI prevention intervention to implement. Measuring compliance with hand hygiene practices recommended by the Centers for Disease Control and Prevention was also identified by 35.5 percent of the respondents as a significant challenge.

"Improving compliance with infection prevention practices requires integration of these practices into the daily tasks of all clinicians," said Premier Safety Institute Vice President Gina Pugliese, RN, MS. "This necessitates a redesign of our systems and processes, such as the use of checklists for critical tasks or strategically placed alcohol-based hand rub dispensers."

In October 2008, changes to the Centers for Medicare & Medicaid Services' (CMS) Inpatient Prospective Payment System (IPPS) will take effect, potentially reducing reimbursement for certain hospital-acquired conditions (HACs), including HAIs. In order to optimize organization readiness for this change, respondents cited accurate and/or appropriate physician documentation of patient records (51.6 percent) and accurate coding, including accurate use of new present on admission (POA) codes (20.2 percent), as the activities needing the most attention.

"The accurate identification and coding of HAIs is going to be challenging without collaboration across multiple areas of the hospital," said Daniel Varga, MD, chief medical officer at SSM Health Care. "Executive leadership needs to work with doctors, nurses, and infection prevention and control staff to ensure that these teams drive system design and culture change."

The survey, conducted by the Association for Professionals in Infection Control and Epidemiology (APIC) and the Premier healthcare alliance, can be accessed at www.premierinc.com/about/news/08-sep/APIC-premier-survey.jsp.

About APIC

APIC's mission is to improve health and patient safety by reducing risks of infection and other adverse outcomes. The association's 12,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities around the globe. APIC advances its mission through education, research, collaboration, practice guidance, public policy and credentialing. Visit APIC online at www.apic.org.

About Premier Inc., 2006 Malcolm Baldrige National Quality Award recipient

Serving more than 2,000 U.S. hospitals and 53,000-plus other healthcare sites, the Premier healthcare alliance and its members are transforming healthcare together. Owned by not-for-profit hospitals, Premier operates one of the leading healthcare purchasing networks and the nation's most comprehensive repository of hospital clinical and financial information. A subsidiary operates one of the nation's largest policy-holder owned, hospital professional liability risk-retention groups. A world leader in helping healthcare providers deliver dramatic improvements in care, Premier is working with the United Kingdom's National Health Service North West and the Centers for Medicare & Medicaid Services to improve hospital performance. Headquartered in San Diego, Premier has offices in Charlotte, N.C., Philadelphia and Washington. For more information, visit www.premierinc.com.

Source: Business Wire

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