211. Infection Prevention Resources and Policies in Acute Care Hospitals: Results from a National Study
Session: Poster Abstract Session: Criticare, HAIs: Pneumonia and Chlorhexidine
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
  • Stone_211_Infection Prevention Resources and Policies in Acute Care Hospitals.pdf (50.4 kB)
  • Background: Knowledge of how best to organize infection control programs to deliver effective care is not clear given contemporary contextual changes such as mandatory reporting of healthcare associated infections (HAI) and increased acuity of hospitalized patients. The objective of this study was to describe the structure and resources of infection control departments around the country and clinician compliance with the implementation of processes to prevent device-associated infections in intensive care units (ICUs).

    Methods: All non-governmental hospitals enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation included:  1) completing a web-based survey, and 2) joining our NHSN research group.  Descriptive statistics and cross-tabulations were computed. The Centers for Disease Control and Prevention (CDC) compared facility characteristics and HAI rates by ICU type between respondents and non-respondents.

    Results: Of 3,374 eligible hospitals, 975 hospitals provided data (29% response rate) on 1,653 ICUs; there were complete data on presence of policies in 1,534 ICUs.  The average number of infection preventionists (IP) per 100 beds was 1.2. Certification of IP staff varied across institutions and the average hours per week of data management and secretarial support were low. Overall, central line-associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) prevention policies were widespread (87-97% and 69-91%, respectively); the presence of catheter-associated urinary tract infection (CAUTI) policies was not as frequent (27-68%). Adherence to policies ranged from 37-71%, 45-55%, and 6-27% for CLABSI, VAP and CAUTI policies respectively. The presence of only two policies differed by ICU type (p<0.05); optimal catheter site selection and use of chlorhexidine for mouth care. There were no differences in HAI rates between respondents and non-respondents.

    Conclusion: This study presents a snapshot of the use and adherence to policies aimed at device-associated HAI in U.S. hospitals. Future studies are needed to analyze the association between infection control department characteristics, presence of, and clinician adherence to, policies and actual HAI rates.

    Patricia Stone, PhD, MPH, RN, FAAN1, Monika Pogorzelska-Maziarz, PhD, MPH1, Carolyn Herzig, MS1, E. Yoko Furuya, MD, MS2, Andrew Dick, PhD3 and Elaine Larson, PhD, RN, FIDSA, FSHEA4, (1)Columbia University School of Nursing, New York, NY, (2)Columbia University, New York, NY, (3)RAND Corporation, Boston, MA, (4)School of Nursing, Columbia University Medical Center, New York, NY


    P. Stone, None

    M. Pogorzelska-Maziarz, None

    C. Herzig, None

    E. Y. Furuya, None

    A. Dick, None

    E. Larson, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.