Program Schedule

850
Preventing Device-Associated Infections in U.S. Hospitals: National Surveys from 2005 to 2013

Session: Poster Abstract Session: Device-Associated HAIs
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Posters
  • Krein IDWeek 9-15-2014 final.pdf (328.6 kB)
  • Background: Numerous initiatives have focused on reducing device-associated infections, including payment policies, mandated reporting of infection rates, and learning collaboratives. Accordingly, recent data from the CDC indicate that device-associated infection rates appear to have declined. However, the specific actions taken by hospitals that may contribute to this decline have not been well-described. We assess use of key practices to prevent device-association infections by U.S. acute care hospitals from 2005 to 2013.

    Methods: We mailed surveys to infection preventionists at a national random sample of ~600 U.S. acute care hospitals in 2005, 2009 and 2013.  Our survey asked about the use of practices to prevent the 3 most common device-associated infections: central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infection (CAUTI).  Using sample weights, we estimated the percent of hospitals reporting regular use (a score of 4 or 5 on a scale from 1, never use to 5, always use) of prevention practices from 2005 to 2013.

    Results: The response rate was ~70% all 3 years.  Use of most recommended practices for preventing CLABSI, VAP and CAUTI increased significantly over time (see Figures).  Among those showing the greatest increase from 2005 to 2013 were use of an antimicrobial dressing for preventing CLABSI (25% to 78%, p < .001), use of an antimicrobial mouth rinse for preventing VAP (41% to 79%, p < .001) and use of catheter removal prompts for preventing CAUTI (9% to 53%, p < .001).  Likewise, a significant increase in facility-wide surveillance was found for all 3 infections, most notably for CLABSI and CAUTI. Practices for which little change was observed included use of antimicrobial catheters to prevent either CLABSI or CAUTI.  

    Conclusion: U.S. hospitals have responded to the call to reduce infection by increasing their use of key recommended practices with nearly universal adoption of maximum barrier precautions, chlorhexidine site disinfectant and semi-recumbent positioning. However, persistent vigilance is needed to ensure sustained improvement and additional strategies may still be required, given an apparent continuing lag in CAUTI prevention efforts.

    Sarah Krein, PhD, RN1,2, Karen Fowler, MPH1, David Ratz, MS1, Jennifer Meddings, MD, MSc2 and Sanjay Saint, MD, MPH1,2, (1)Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, (2)Department of Internal Medicine, Division of General Medicine, University of Michigan Medical School, Ann Arbor, MI

    Disclosures:

    S. Krein, Blue Cross and Blue Shield of Michigan Foundation: Grant Investigator, Research grant and Research support
    Department of Veterans Affairs: Employee and Investigator, Research support and Salary

    K. Fowler, Blue Cross and Blue Shield of Michigan Foundation: Investigator, Research support
    Department of Veterans Affairs: Employee, Research support and Salary

    D. Ratz, Blue Cross and Blue Shield of Michigan Foundation: Investigator, Research support
    Department of Veterans Affairs: Employee, Research support and Salary

    J. Meddings, SHEA: Member, Speaker honorarium
    QuantiaMD: invited speaker/developer for educational webinar, Speaker honorarium

    S. Saint, Blue Cross and Blue Shield of Michigan Foundation: Grant Investigator, Grant recipient, Research grant and Research support
    Department of Veterans Affairs: Employee and Investigator, Research support and Salary

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