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June 22, 2012

HHS National Action Plan to Eliminate Healthcare Associated Infections

Hosptial Infections
The Department of Health and Human Services (HHS) posted online an updated National Action Plan to eliminate healthcare-associated infections for public comment.  The update confirms progress in the effort to make healthcare safer and less costly by reducing preventable complications of care, including healthcare-associated infections (HAIs).  

Every day, approximately 1 in every 20 patients has an infection related to the patient’s hospital care.  These infections cost the U.S. healthcare system billions of dollars each year and lead to the loss of tens of thousands of lives.  In addition, HAIs can have devastating emotional, financial and medical consequences.  

“Today, we celebrate the rapid progress achieved through concerted efforts to reduce preventable infections in hospitals,” said Dr. Howard Koh, assistant secretary for health. “Already we are saving lives and reducing unnecessary healthcare expenditures. Through dedicated and conscientious partnerships, we are well-positioned to make hospitals safer and extend the same gains to all places of care.”  

A new state-by-state breakdown by the Centers for Disease Control and Prevention (CDC) demonstrates that HAIs in hospitals have been declining since HHS first introduced its National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination in 2009.  The CDC report also pinpoints specific medical procedures that require stronger infection prevention efforts to maximize patient safety. 

According to data submitted to CDC’s National Healthcare Safety Network and reported in the HAI Action Plan, central line-associated bloodstream infections have declined by 33 percent, surgical site infections (SSIs) have declined by 10 percent, and catheter-associated urinary tract infections have declined by 7 percent since the baselines were set

In addition, invasive Methicillin-resistant Staphylococcus aureus (MRSA) infections have declined by 18 percent, and the use of measures known to prevent SSIs, as reported by the Centers for Medicare and Medicaid Services’ Surgical Care Improvement Project, have steadily increased since the baseline was established.  These reductions are in line with the prevention targets detailed in the HAI Action Plan and the HHS Partnership for Patients initiative. 

“We need a comprehensive approach for tackling infections in the nation's healthcare facilities, as patients can seek care from a variety of locations and move between healthcare facilities," said CDC Director Thomas R. Frieden. "CDC's National Healthcare Safety Network is a critical tool for states to do prevention work. Once a state knows where problems lie, it can better assist facilities in correcting the issue and protecting patients.”  

The HAI Action Plan has nine goals: 

  • 50 percent reduction in bloodstream infections
  • 100 percent adherence to central line insertion practices
  • 30 percent reduction in Clostridium difficile infections
  • 30 percent reduction in Clostridium difficile hospitalizations
  • 25 percent reduction in urinary tract infections
  • 50 percent reduction in MRSA invasive infections (in the general population)
  • 25 percent reduction in MRSA bacteremia
  • 25 percent reduction in surgical site infections
  • 95 percent adherence to surgical SCIP measures. 

The rates of one type of infection remain at historic highs.  Clostridium difficile (C. difficile) is a germ that causes serious diarrhea, kills 14,000 Americans each year and adds an estimated $1 billion in extra costs to the healthcare system. While many HAIs declined in the 2000s, data from the Agency for Healthcare Research and Quality show that the number of hospital stays associated with C. difficile tripled before leveling off at historic high rates.  

In addition, a recent CDC report showed that C. difficile infections have moved beyond hospitals and that 75 percent of these infections now begin in medical settings outside hospitals, such as nursing homes and outpatient clinics.  

Since 2009, the HAI Action Plan has marshaled resources across HHS, several other federal agencies, and numerous stakeholders in a concerted effort to substantially reduce HAIs by 2013.  Phase one of  that effort focuses on combating HAIs in hospitals, while phase two focuses on ambulatory surgical settings, end-stage renal disease facilities, and the influenza vaccination of healthcare personnel.  A new third phase, to initiate next summer, will focus on long-term care facilities.  Although much has been accomplished under the HAI Action Plan, much remains to be done to improve patient safety throughout the healthcare system. 

An announcement of the request for public comments on the National Action Plan was published in the Federal Register the week of April 23.    

The HHS Partnership for Patients works to accelerate progress against HAIs through highly structured learning collaboratives to support hospitals nationwide in adopting and helping to spread proven interventions so that they become the standard of care. The Partnership for Patients is a nationwide public-private collaboration focused on keeping patients from getting injured or sicker in the hospital, and helping patients heal without complication once they are discharged.  Other Partnerships for Patients partners, including state and national associations, consumer groups, unions, employers, researchers, community-based organizations, patients and others also are collaborating to help to accelerate progress against HAIs and other preventable conditions.  HHS welcomes additional partners in these efforts to build the healthcare system that Americans need, desire and deserve.

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