U.S. makes progress in HAI prevention

Lunched in 2010 by the U.S. Department of Health and Human Services (HHS), the National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination (Action Plan) shows progress in prioritizing HAI preventing practices and coordinating diverse national data sources for tracking HAIs.

A 3-year evaluation of the Action plan identifies what’s working and the challenges that remain for national effort. “There is widespread recognition of the personal and financial costs associated with HAIs, including the potential for loss of life or impaired functioning, billions of dollars spent annually to treat HAIs, and decreasing public trust in the healthcare system,” according to an overview by Dr. Katherine L. Kahn of RAND and colleagues. “The goal of the HHS Action plan is to enhance collaboration and coordination and strengthen the impact of national efforts to address HAIs.”

A key first step in the Action Plan was the selection of six top-priority HAIs:

  • catheter-associated urinary tract infection,
  • surgical site infection,
  • Clostridium difficile infection,
  • central line-associated bloodstream infection,
  • methicillin-resistant Staphylococcus aureus (MRSA), and
  • ventilator-associated events.

A second major focus was to improve collaboration and coordination of the HAI data systems maintained by various HHS agencies. Along with Daniel Weinberg, PhD, of IMPAQ, Kahn coauthored a study examining the strengths and weaknesses of data systems for monitoring priority HAIs. The authors highlight the importance of clinical validity, ability to capture a broad range of HAIs, large samples, representativeness, and consistency of cohort, surveillance definition, and system function. Using the available databases, the authors found concordance in HAI trend rates for most, but not all, priority HAIs.

“The potential for alignment offers opportunities to leverage existing resources and capabilities within the health care system on an ongoing basis,” Kahn and colleagues write. They add that “regular evaluation of HAI-related efforts, including self-monitoring of key implementation goals” will also be essential to ensure that efforts to track and respond to HAIs stay on track in the years ahead.