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Compendium of strategies full of HAI prevention tips


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Five major organizations collaborated in October to create a compendium of strategies to prevent six of the most common healthcare-associated infections (HAI).

The information won’t likely be new for infection control professionals (ICPs) who have been working from the same guidelines for years, but its release sends a strong political message to hospital leadership, says Maureen Spencer, RN, MEd, IC manager at New England Baptist Hospital in Boston and an APIC member.

Most ICPs could use a boost from their leadership these days. “It’s clear that many ICPs don’t have enough people to do what [regulators and government officials] want us to do,” Spencer says. (See “What do ICPs need?” below for more information.)

Despite the Centers for Disease Control and Prevention's estimation that one of every 10–20 patients hospitalized in the United States develops an HAI, with 90,000 deaths and up to $6.5 billion in extra costs, infection control (IC) departments are still competing for resources while they struggle to implement a host of new recommendations and requirements.

Spencer says she hopes this initiative will provide more incentive to hospital leaders to allocate the funding IC programs need.

The compendium also has value as a resource, says Connie Steed, MSN, RN, CIC, director of IC at Greenville (SC) Hospital System.

“I think that the compendium was very well done and it helps in areas where we haven’t had any updated guidance in a while,” says Steed. Although most ICPs will be familiar with the information, it could equate to more leverage, she adds.

The document, titled A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals, was produced by the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America in partnership with the American Hospital Association, APIC, and The Joint Commission (formerly JCAHO).

Six targets

Although the recommendations mirror previous guidelines, they’re designed to be more practical, concise, and helpful to hospitals implementing and prioritizing their HAI prevention efforts.

The infections targeted in the compendium include:

  • C. diff
  • MRSA
  • Central line-associated bloodstream infections
  • Ventilator-associated pneumonia
  • Catheter-associated urinary tract infections
  • Surgical site infections

Representatives from the five organizations unveiled the recommendations at an October 8 press conference at the National Press Club in Washington, DC. “The best strategies have never been in one place in an easy-to-use form as they are in right now,” said Robert Wise, MD, vice president of the division of standards and survey methods at The Joint Commission. In 2009, The Joint Commission says it expects hospitals to examine their risks and current practices to decide which of the recommendations in the compendium they’ll need to institute.

The accreditor will also decide which of the compendium strategies to add to its hospital standards in 2010, Wise said.

“I think it’s a great idea to combine all the requirements in one place. That is long overdue,” says Terry Burger, BSN, RN, CIC, CNA, BC, director of infection prevention and control at Lehigh Valley Hospital in Allentown, PA. Putting the requirements in one place will make it easier for ICPs to find best practices to prevent these HAIs.

“To have it all in one-stop shopping is pretty nice. I have one place to direct my ICPs so everyone is singing off the same sheet of music, so to speak,” Burger says.

Upon reviewing the authorship of the compendium recommendations, Burger says she would like to have seen more RNs and medical technicians included in the project. She also would have appreciated the organizations sharing the recommendations with their members before the compendium was released to the media.

Copies of the recommendations can be found at www.journals.uchicago.edu/toc/iche/2008/29/s1.

What do ICPs need?

Aside from funding, which of the following is the most important resource to meet your current infection prevention challenges?

  • Adequate staffing for infection prevention: 42.2%
  • Information technology and support: 25.1%
  • Visible support from clinical leaders: 16.3%
  • Visible support from administration: 14%
  • Other: 2.5%

Source: APIC and Premier healthcare alliance, September survey. Reprinted with permission.