1228. Aggregate Impact of Recovery Act Funded Prevention Collaboratives on Device- and Procedure-Associated Infections
Session: Oral Abstract Session: Impact of National Policy on HAI Reporting and Prevention
Friday, October 19, 2012: 2:15 PM
Room: SDCC 32 AB

Background: In 2009, 27 state health departments received funding through the American Recovery and Reinvestment Act (ARRA) to implement healthcare-associated infection prevention collaboratives. Examining the aggregate impact of these multi-facility collaboratives is an essential step in characterizing return-on-investment for ARRA funding. Our objectives were to assess whether changes over time in central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI), and surgical site infections (SSI) differed between states that used ARRA-funds to implement collaboratives and those that did not.

Methods: Quarterly standardized infection ratios (SIR) were calculated for CLABSI, CAUTI, and SSI using National Healthcare Safety Network surveillance data from 20092011. SIRs were stratified by state prevention collaborative status, determined by reported implementation of prevention collaboratives on quarterly reports. For each infection type, stratified trends over time were assessed using weighted linear regression to model SIRs; differences in trends for states with and without ARRA-funded prevention collaboratives were assessed with an interaction term.

Results: States used ARRA funding to implement 49 device- and procedure-associated collaboratives (16 CLABSI, 11 CAUTI, and 12 SSI). CLABSI SIRs decreased in both states that used ARRA funds for implementation of CLABSI collaboratives and those that did not; there was no statistical difference in the rate of decrease (p=0.1). The decrease in CAUTI SIRs was statistically greater over time in states that used ARRA funds to implement CAUTI collaboratives compared to those that did not (p=0.02). There was no difference in the rate of SSI decline across strata (p=0.9).

Conclusion: ARRA-funding allowed states the flexibility to prioritize prevention efforts, and statistically accelerated decreases in CAUTI were noted in states that used ARRA funds for implementing CAUTI prevention collaboratives compared to those that did not. Non-significant differences for CLABSI and SSI trends might reflect an abundance of non-ARRA related prevention efforts targeting these infections during this same time period.


Katherine Ellingson, PhD1, Kelly McCormick, MSPh1, Ronda Sinkowitz-Cochran, MPH1, Tiffanee Woodard, MFT1, John A. Jernigan, MD, MS1, Arjun Srinivasan, MD, FSHEA1, Jonathan Edwards, MStat1, Kimberly Rask, MD, PhD1,2 and The State-Based Healthcare-Associated Infection Public Health Analyst Team, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)Rollins School of Public Health, Emory University, Atlanta, GA


K. Ellingson, None

K. McCormick, None

R. Sinkowitz-Cochran, None

T. Woodard, None

J. A. Jernigan, None

A. Srinivasan, None

J. Edwards, None

K. Rask, None

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