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CDC: Hospitals Report 'Impressive' Drop in Health Care Infections

By John Reichard, CQ HealthBeat Editor

October 19, 2011 -- Central line infections—which are associated with tubes placed in the neck or chest of a hospital patient to deliver important medicines—dropped by 33 percent in 2010, according to an analysis announced Wednesday by the Centers for Disease Control and Prevention (CDC).

The agency also reported a 10 percent drop in surgical site infections and a 7 percent decline in hospital infections associated with catheters inserted in the urinary tract. And the number of people who contracted methicillin-resistant Staphylococcus aureus (MRSA) infections from health care facilities declined by 18 percent.

The findings suggest that health care services can be retooled in a way that improves safety and lowers costs when the public and private sectors unite on achieving specific goals.

CDC Director Thomas R. Frieden said in a news release that hospitals “continue to make impressive progress in driving down certain infections in intensive care units through implementation of CDC prevention strategies.”

Declines weren’t limited to intensive care units, but Frieden said that in general hospitals and state health departments need to do more to extend progress in ICU units to other areas of health care delivery and to other types of health care infections. He cited as examples dialysis and ambulatory surgery centers and diarrheal infections such as clostridium difficile.

Central line infections are particularly serious because they involve patients who are critically or seriously ill. These infections occur when the central line tube is inserted improperly or isn’t kept clean.

When that happens, “central lines can become a freeway for germs to enter the body and cause serious bloodstream infections,” the CDC news release said.

Frieden revealed the findings at a policy forum in Washington, D.C. sponsored by the National Journal.

Infection reduction is the goal of a variety of public and private sector efforts that go back a decade or more.

The “100,000 Lives” campaign launched in 2004 by the Boston-based Institute for Healthcare Improvement” targeted central line and surgical site infections among other safety goals. Some 3,000 hospitals participated in the voluntary campaign led by Centers for Medicare and Medicaid Services (CMS) Administrator Donald M. Berwick, the head of the institute at the time.

On other fronts, states have passed laws requiring public reporting of central line infections in the ICU, the CDC launched a major initiative targeting health care associated infections, and under the health overhaul law (PL 111-148, PL 111-152) Medicare will cut payments to facilities with many such infections.

“I don’t think we can point to any one thing” to explain the improvements, said CDC spokesperson Abbigail Tumpey.

Tumpey noted that 28 states have passed laws requiring some form of public reporting of central line infections. “It really results in culture change in many of these hospitals,” she said.

Based on CDC work with Pennsylvania hospitals and an easy-to-follow checklist developed by Peter Pronovost of Johns Hopkins University, CDC recommendations have spurred hospital staff to take a variety of steps to prevent the infections, she added. Hospitals that carefully follow the checklist have reduced the infections by 70 percent, she said.

And CMS now requires hospitals that have a central line infection to report it to the agency as part of an emerging program under the health law to lower Medicare payments when health care-associated infections occur. The agency’s voluntary “Partnership for Safety” program launched this year seeks to widen improvements in reducing infections and enhancing safety.

The specific declines reported by CDC Wednesday were against various national averages or “baselines.” The 33 percent drop in central line infections occurred relative to a national average based on 2006–2008 data. The drop that occurred in 2009 against that average was 18 percent, suggesting continuing steady improvement in 2010.

The 10 percent drop in surgical site infections was compared to a national average calculated from 2006-2008 data. The 2009 drop compared to that average was 2 percent.

The 7 percent decline in catheter-related infections was compared to a 2009 average. And the 18 percent reduction in MRSA infections was compared to a national average calculated from 2007-2008 data. The 2009 decline against that baseline was 12 percent.

Pennsylvania program
State infection tracking
Detailed CDC data on improvements

John Reichard can be reached at [email protected] .  

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