Healthcare Associated Infections Toolkit from eQHealth Solutions, the Medicare QIO for Louisiana

Combatting Healthcare Associated Infections (HAIs)

As the Quality Improvement Organization for Louisiana, we are pleased to freely share knowledge and tools for improving health quality, efficiency and value.

In 2008, the Department of Health and Human Services (DHHS) released the HHS Action Plan to Prevent Healthcare-Associated Infections.[1] HAIs are infections that patients acquire while receiving treatment for medical or surgical conditions.

HAIs are associated with a variety of causes, including (but not limited to) the use of medical devices, such as catheters and ventilators, complications following a surgical procedure, transmission between patients and healthcare workers, or the result of antibiotic overuse. They are among the leading causes of death in the United States, accounting for an estimated 1.7 million infections and 99,000 associated deaths in 2002. In hospitals, they are a significant cause of morbidity and mortality.[2]

Four categories of infections account for approximately three quarters of HAIs in the acute care hospital setting including 1) surgical site infections; 2) central line-associated bloodstream infections; 3) ventilator-associated pneumonia, and; 4) Catheter-Associated Urinary Tract Infection (CAUTI).

In addition, infections associated with Clostridium difficile and methicillin-resistant Staphylococcus aureus also contribute significantly to the overall problem. The frequency of HAIs varies by location. Currently, urinary tract infections comprise the highest percentage (34%) of HAIs followed by surgical site infections (17%), bloodstream infections (14%), and pneumonia (13%).[2] It is estimated that HAIs incur an estimated $28 to $33 billion in excess healthcare costs each year.[3]

Below you will find links to general resources. On the right are links to pages with more detailed resources.

Tools & Resources

PDF of the January 11, 2012 presentation "Building a Team and Tools to Reduce CAUTI Risk "

PDF of the December 14, 2011 Science of Safety presentation

APIC Elimination Guides

CDC HAI Web Site

CDI Guidelines Summary - Guideline Clearinghouse

CDC Hand Hygiene Guidelines

CDC Hand Hygiene in Health Care Settings

CDC Hand Hygiene Patient Education Materials

CDC Hand Hygiene Resources

CDC Measuring Hand Hygiene Compliance/Overcoming Challenges

SHEA Compendium on Reducing HAIs

CDC/HICPAC Isolation Guidelines

MDRO CDI Module Protocol

Hand Hygiene Monitor Tool sample 1 (Word) (PDF)

Hand Hygiene Monitor Tool sample 2 (Word) (PDF)

Hand Hygiene Observation Tool (Word) (PDF)

Infection Prevention Society, United Kingdom - Quality Improvement Tool for a variety of settings

Infection Prevention Society, United Kingdom - Infection Prevention Quality Improvement Tools for In & Outpatient Departments

Infection Control Assessment Tool

Accident Investigation: Causal Factors & Corrective Actions (Word) (PDF)

Infection Prevention Regulations, Standards, etc. - Comprehensive listing (Word) (PDF)

The Direct Medical Costs of HAIs (Article)

Infectious Disease Epidemiology Section of the Office of Public Health (Louisiana): Healthcare Associated Infection Resource Center

HHS Office of Healthcare Quality

HHS Office of Healthcare Quality Action Plan to Prevent Healthcare-Associated Infections

CDC Healthcare-associated infections (HAIs): State Plans to Address HAIs

References
1. HHS HAI Initiatives Document
2. Klevens RM, et al. Estimating Health Care-Associated Infections and Deaths in U.S. Hospitals, 2002. Public Health Reports 2007; 122:160-166.
3. Scott Rd. The Direct Medical Costs of Healthcare-Associated Infections in U.S. Hospitals and the Benefits of Prevention, 2009. Division of Healthcare Quality Promotion, National Center for Preparedness, Detection, and Control of Infectious Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, February 2009.