Hospitals still struggle to prevent avoidable costly and deadly healthcare-associated infections (HAIs), according to a new survey.
The survey was released Monday by the Association for Professionals in Infection Control and Epidemiology at APIC's annual conference, being held this year in New Orleans.
According to APIC, an estimated 80,000 patients develop catheter-related bloodstream infections (CRBSIs) each year in the United States, and about 30,000 die, accounting for roughly one-third of the 99,000 deaths that occur each year from HAIs. The average cost of care for a patient with this type of infection can exceed $30,000, costing the U.S. healthcare system more than $2 billion annually.
APIC researchers said the survey was designed to uncover barriers to hospital adoption of best practices to prevent CRBSIs. Half of those surveyed said CRBSIs continue to be a problem in their facilities and cited lack of time,resources, and the commitment of hospital leadership as hindering theirability to combat these infections more aggressively.
About half of survey respondents agree that they spend so much time on surveillance or reporting that they don't have time to work on CRBSI prevention. Seven in 10 said they don't have enough time to train others adequately on how to prevent bloodstream infections.
"Bloodstream infections from catheters are nearly 100 percent preventable with clear, actionable steps," said APIC 2010 President Cathryn Murphy, RN. "Many hospitals have seen their rates decline dramatically – some have gotten to zero and have maintained that. It is disturbing that some hospitals still report having difficulty implementing best practices to avoid these infections."
AHIP researchers said survey results were collected from 2,075 respondents, including APIC members, members of the Infusion Nurses Society and the Association for Vascular Access. For the purposes of the survey, researchers said they defined CRBSIs to include infections resulting from central lines, peripheral lines, dialysis lines and implanted ports.
According to APIC, there are nationwide examples of success in preventing CRBSIs, considered by the federal government to be preventable through evidence-based practices.
Peter Pronovost, MD, has had success in intensive care units in Michigan hospitals, reducing the incidence of CRBSIs by two-thirds and saving more than 1,500 lives and $200 million in the first 18 months of the project, APIC leaders said. Participating hospitals followed a five-step checklist, which is being replicated in many hospitals.
"Despite the evidence demonstrating that many, if not most, CRBSIs can be prevented through consistent application of best practices and the financial penalty imposed by CMS and many private insurers, CRBSIs are still a persistent problem for many healthcare institutions," said APIC CEO Kathy Warye. “Elimination of CRBSIs needs to be the goal of every healthcare institution."
Half of the survey's respondents strongly agreed that their hospital administration knows the extent to which CRBSIs are a problem, but only 30 percent said their administration is willing to spend the money necessary to prevent the infections. Only one in four respondents strongly believed their facility monitors compliance with best practices for the prevention of bloodstream infections or holds clinical staff accountable for adhering to these practices.
"Preventing infections requires the full commitment of hospital leadership to ensure adequate resources and instill a culture of patient safety within the institution," said Pronovost, who is the lead clinical advisor to APIC on the CRBSI initiative and professor at the Johns Hopkins University School of Medicine.
"If infection prevention is a priority for leadership, it will be a priority for the rest of the institution," he said. "All facilities need to address the barriers to prevention and begin now to implement comprehensive efforts to prevent HAIs."