State of infection prevention in US hospitals enrolled in the National Health and Safety Network

doi:10.1016/j.ajic.2013.10.003

American Journal of Infection Control

Volume 42, Issue 2, February 2014, Pages 94-99

https://doi.org/10.1016/j.ajic.2013.10.003 Get rights and content

Background

This report provides a national cross-sectional snapshot of infection prevention and control programs and clinician compliance with the implementation of processes to prevent health care–associated infections (HAIs) in intensive care units (ICUs).

Methods

All hospitals, except Veterans Affairs hospitals, enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation involved completing a survey assessing the presence of evidence-based prevention policies and clinician adherence and joining our NHSN research group. Descriptive statistics were computed. Facility characteristics and HAI rates by ICU type were compared between respondents and nonrespondents.

Results

Of the 3,374 eligible hospitals, 975 provided data (29% response rate) on 1,653 ICUs, and there were complete data on the presence of policies in 1,534 ICUs. The average number of infection preventionists (IPs) per 100 beds was 1.2. Certification of IP staff varied across institutions, and the average hours per week devoted to data management and secretarial support were generally low. There was variation in the presence of policies and clinician adherence to these policies. There were no differences in HAI rates between respondents and nonrespondents.

Conclusions

Guidelines for IP staffing in acute care hospitals need to be updated. In future work, we will analyze the associations between HAI rates and infection prevention and control program characteristics, as well as the inplementation of and clinician adherence to evidence-based policies.

Section snippets

Methods

This was a mixed-methods study that included both qualitative and quantitative approaches. The qualitative results, which are reported elsewhere, informed the quantitative approach described here.¹² Specifically, based on the qualitative results, we adapted the survey from our previous research (which was originally adapted from the SENIC study).8, 9, 10, 11

All hospitals, except for Veterans Affairs hospitals, were eligible to participate if they were enrolled in the National Healthcare Safety

Results

Of the 3,374 eligible hospitals, 975 provided data (29% response rate) on 1,653 ICUs, and there were complete data on the presence of policies in 1,534 ICUs. Table 1 summarizes the characteristics of these facilities. The hospitals are located in all settings across the nation with the largest proportions being rural (42%), in the South (36%), nonteaching (66%), and not for profit (75%). The hospitals have an average of 52,578 annual patient-days with 11,377 admissions, 32 ICU beds, 12

Discussion

This study provides the most comprehensive examination to date of the structures and support of infection prevention and control programs in the US since the SENIC study. We analyzed infection prevention and control programs and processes in adult ICUs of almost 1000 acute care hospitals across the nation, and evaluated clinician adherence to these processes. We found considerable variation in the organization and structure of infection prevention and control programs across the nation.

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: Conflict of interest: None to report.

: This study was funded by the National Institute of Nursing Research (grant R01NR010107). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research, the National Institutes of Health, or the Centers for Disease Control and Prevention. In addition, this research was supported in part by an appointment to the Research Participation Program at the Centers for Disease Control and Prevention, administered by the Oak Ridge Institute for Science and Education.

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Major articleState of infection prevention in US hospitals enrolled in the National Health and Safety Network

Background

Methods

Results

Conclusions

Section snippets

Methods

Results

Discussion

Am J Infect Control

Am J Infect Control

Am J Infect Control

Clin Microbiol Infect

Jt Comm J Qual Patient Saf

Am J Infect Control

Am J Infect Control

Mayo Clin Proc

Am J Infect Control

Am J Infect Control

To err is human: building a safer health system

Major article
State of infection prevention in US hospitals enrolled in the National Health and Safety Network