Phase I: Acute Care Hospitals– Addresses most common infections found in the ACH inpatient setting. Policy options for linking payment incentives or disincentives to quality of care and enhancing regulatory oversight of hospitals. This HAI Action Plan includes five-year goals for eight specific measures of improvement in HAI prevention.
Phase II: Ambulatory Surgical Centers, End-Stage Renal Disease Facilities, and Increasing Influenza Vaccination among Health Care Personnel. Extending its scope to the outpatient environment and addressing the health and safety of health care workers, as well as the risks of transmission of influenza from health care personnel to patients.
“In 2000, it was estimated that the burden of HAIs ranges from 1.6 to 3.8 million infections among 1.5 million Americans in 16,700 U.S. NHs/SNFs every year.1 Data used to calculate these burden estimates were limited to reports from research studies involving small numbers of facilities using different methodologies to define HAIs. Additionally, these studies represent NHs and SNFs exclusively and were conducted more than 10 years ago. Data are lacking from other long-term care settings, such as assisted living facilities, residential care facilities, and independent senior living communities. These burden estimates, therefore, may not reflect the current population residing within the full spectrum of LTCFs.”
NATIONAL ACTION PLAN TO PREVENT HEALTH CARE-ASSOCIATED INFECTIONS: ROAD MAP TO ELIMINATION APRIL 2013 Click or tap to read Chapter 8: Long-Term Health Facilities
Challenges for HAI Prevention in Long-Term Care Settings
NHs/SNFs must maintain infection control and prevention (ICP) programs to comply with the federal regulations governing licensing and certification. The expectations for those programs are outlined within the Interpretive Guidance for Infection Control at F tag 441, last revised by CMS in December 2009.66 Most NHs/SNFs lack adequately trained and committed personnel and resources for this task. A study from Maryland demonstrated that the number of infection preventionists (IPs) in NHs is fourfold lower than the number of IPs in acute care facilities of similar size. The vast majority of NH/SNF IPs have multiple titles and work part-time on infection prevention regardless of bed size or acuity of the residents cared for in their facilities. Additionally, less than 10% of IPs in NHs/SNFs have any specific ICP training (e.g., Certification in Infection Control) compared with more than 95% of acute care IPs.
Health Care-Associated Infections Metrics for Long-Term Care Facilities
Consistent with other phases of the HAI Action Plan, there is a focus on HAIs that are nationally burdensome, due to high prevalence or high cost, and known to be preventable through implementation of evidence-based care practices. Based on the literature reviewed, the following HAIs were proposed: (1) UTIs, including CAUTIs and catheter care processes, and (2) Clostridium difficile infections (CDIs).
Two additional priority modules focus on vaccination of residents and HCP to prevent influenza and pneumonia. The inclusion of these vaccine priorities supports the HCP influenza vaccination module included in Phase Two of the HAI Action Plan and the current CMS NH/SNF quality measures promoting resident vaccinations. Furthermore, these vaccine measures are consistent with national vaccination goals in the Healthy People 2020 objectives.
For more information please visit Centers for Disease Control and Prevention/NHSN