HyGreen Examines the Role of Hand Hygiene in Healthcare Associated Infections

Proper hand hygiene is the single most important evidence based practice to help eliminate cross-contamination and reduce the incidence of healthcare-acquired infections (HAIs).

To raise awareness about hand hygiene and HAIs, several activities are scheduled internationally during the month of October.   October 15th is Global Handwashing Day, promoting handwashing in an effort to prevent infections.   October 14 – 20, 2012 is International Infection Prevention Week (IIPW).  Founded by the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), IIPW provides a focal point for infection preventionists, healthcare professionals, and consumers on infection prevention and its power to save lives.

Despite the importance of hand washing, numerous articles have been written about the lack of hand hygiene in health care facilities.  Below are referenced quick facts on hand hygiene and its importance in infection prevention:

  • It is well established that the hands of HCWs are the principal cause of transmission of infection from patient to patient.9 
  •  Hand hygiene, a very simple action, remains the primary means to reduce HAI’s and the spread of antimicrobial resistant organisms.2-5
  •  Global research indicates that improvements in hand hygiene activities could potentially reduce HAI rates by up to 50%.4,8
  •  In the U.S., healthcare associated infections (HAI’s) affect more than 2 million people every year resulting in approximately 100,000 deaths.1
  •  HAI’s lead to long-term disability, preventable deaths, and additional financial burden on the healthcare system.6
  •  An HAI increases the average length of stay 7.4 to 9.4 days and the risk of morbidity by 35%.9
  •  Compliance by healthcare workers with optimal hand hygiene is considered to be less than 40%.7
  •  Several studies of hand washing in high-acuity units with vulnerable patients have found that as few as one in seven staff members wash their hands between patients: compliance rates in the range of 15% – 35% are typical; rates above 40% are the exception.10-11 

To shine a light on infection prevention and its power to save lives, HyGreen has developed a video entitled “Healthcare Associated Infection by the Numbers.” This video breaks down the impact of infections on the lives of patients and the healthcare system.

To learn more about HyGreen and electronic hand hygiene monitoring, join our upcoming webinar on October 25th by registering at www.hygreen.com.

 

1Klevens RM, Edwards JR, Richards CL, Jr., et al. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep 2007; 122:160-166.

2 Pittet D, Mourouga P, Perneger TV. Compliance with handwashing in a teaching hospital: infection control program. Ann Intern Med. 1999;130(2):126-130.

3 World Health Organisation. WHO Guidelines on Hand Hygiene in Health Care. Geᆳneva, Switzerland: World Health Organisation; 2009. http://whqlibdoc.who.int/publicaᆳtions/2009/9789241597906_eng.pdf. Accessed July 15, 2009.

4 Pittet D, Hugonnet S, Harbarth S, Mourouga P, Sauvan V, Touveneau S, Perneger TV. Effectiveness of a hospital-wide programme to improve compliance with hand hygiene. Infection Control Programme. Lancet 2000 Oct 14;356(9238):1307-12.

5 Sax H, Allegranzi B, Uçkay I, Larson E, Boyce J, Pittet D. ‘My five moments for hand hygiene’: a user-centred design approach to understand, train, monitor and report hand hygiene. J Hosp Infect. 2007 Sep;67(1):9-21. Epub 2007 Aug 27.

6Backman, Chantal, RN, BScN, MHA “Patient Safety: It’s in your hands!” PowerPoint presentation, slide 15.

7Gautham Suresh, M.D., D.M., M.S., Cahill, John, M.D., “National Patient Safety Goals. How ‘User Friendly’ is the Hospital forPracticing Hand Hygiene?: An Ergonomic Evaluation.” The Joint Commision Journal on Quality and Patient Safety 33. 3 (March 2004).

8Brachman PS, Dan BB, Haley RW, Hooten TM, Farner JS, Allen JR. Nosocomial surgical infections: incidence and cost. Surg Clin North Am 1980;60:15-25.

9Larson, E. (1988). A causal link between handwashing and risk of infection? Examine the evidence. Infection Control, 9(1), 28-36.10Albert. R.K. & Condie, F. (1981). Handwashing patterns in medical intensive-care units. New England Journal of Medicine, 304(24), 1465-1466.

11Graham, M. (1990). Frequency and duration of handwashing in an intensive care unit. American Journal of Infection Control, 18(2), 77-81.

Posted in Articles | 1 Comment

A new perspective looking at healthcare-associated infections from the other side of the bed

This article gives a unique perspective into a patient who got a healthcare associated infection while in the hospital and was chronicled by his wife, an infection preventionist. Improper hand hygiene resulting in an HAI will impact him for the rest of his life.

A New Perspective

Posted in Articles | Tagged , , , | Leave a comment

Hand Hygiene in Nursing Homes – How often do the caretakers of the elderly wash their hands?

A recent article in the New York Times entitled, “The New Old Age: The Dirty Little Secret of Nursing Homes” explores the lack of healthcare worker hand washing in nursing homes and the impact on patients.

To read more, go to:   http://nyti.ms/NshFxl

Posted in Articles | Leave a comment

HyGreen Installed at the Wilkes-Barre VA Medical Center

See the news release published by the Wilkes-Barre VAMC:

http://www.wilkes-barre.va.gov/features/HyGreen_Hand_Hygiene_System.asp

Posted in Articles | Leave a comment

CMS Reveals Central Line Infection Rates, Finally

Cheryl Clark, for HealthLeaders Media, February 9, 2012

For the first time, the Centers for Medicare & Medicaid Services has added to its Hospital Compare website the rates of central line-associated bloodstream infections, or CLABSIs, for specific hospital intensive care units, at least those collected to date.

The Centers for Disease Control and Prevention estimates these terrible, but preventable infections killed 10,000 of the 41,000 patients who acquired them while being cared for in U.S. intensive care units in 2009. Providing the additional care the infections required added $700 million to the healthcare bill.

To read more, CLICK HERE 

Posted in Articles | Tagged , , , , | Leave a comment

Hospital Errors Often Unreported

One condition of receiving Medicare payments is that hospitals are required to report, track and analyze medical events that harm patients. The expectation is that hospitals will use this information to change, adapt or improve their policies or practices so that preventable errors do not injure future patients.

 A report by the inspector general of the Department of Health and Human Services (HHS), Daniel R. Levinson, found that only one in seven Medicare patient harms or accidents are actually reported by hospital staff, even though they are required by law to do so. Even serious errors like hospital-acquired infections and fatalities are going unreported, and are just as likely to be unreported as other errors, including bedsores, delirium from too much pain medication, and allergic reactions to medications.

 Mr. Levinson said there could be a number of reasons why hospital employees are not reporting these errors, such as not recognizing what “constitutes a patient harm,” not knowing which harms needed to be reported, believing another employee will report the harm, or thinking the harm was either so common or so unique (and thus unlikely to happen again) to require reporting.

 Further, according to the New York Times, the report found that even when errors are reported and analyzed, little effort was made to amend hospital policies and procedures to prevent the potential repetition of errors.

The HHS report is only looking at instances involving Medicare patients, situations in which the law requires hospitals to examine patient safety through reports, analysis and the implementation of change. So, when six out of seven errors are not being reported when required, important questions are raised about safety concerns for all patients.

Posted in Articles | Tagged , , , | Leave a comment

C. diff Infection Source Unclear

Only 25 percent of hospital-associated Clostridium difficile infections can be traced to contact with a symptomatic patient in one particular hospital system, according to new research. Surveying  recent diarrhea cases in one county in England, the study, published in PLoS Medicine today (February 7), throws the effectiveness of costly prevention strategies typically employed by hospitals into doubt.

The study is “ambitious and far-reaching in its conclusions,” said Kent Sepkowitz, a clinical epidemiologist at Sloan Kettering Memorial Hospital in New York who was not involved in the research. “It shakes the foundation of what we understood” about hospital-associated C. diff infections.

C. difficile is a spore-forming bacterial species associated with severe, sometimes fatal, diarrhea. It’s unclear how many healthy, asymptomatic adults carry C. diff in their colons, but in times of ill health, and especially after broad-spectrum antibiotic treatment, it can overgrow and cause disease. C. diff produces several types of toxins—A, B and CDT. Most strains produce only one, but the hypervirulent O27 strain, which caused epidemics of C. diff infection during the early 2000s, can produce all three. C. diff can remain viable in the environment for long periods of time after generating spores that are resistant to heat, alcohol-based disinfectants, and routine surface cleaning. C. diff outbreaks are recurrent problems in hospitals and elderly care facilities, but can also be “community-acquired”—meaning infections occur outside of hospitals.

In the United Kingdom, where C. diff reporting has been mandatory since 2007, its prevalence is an indicator of hospital quality, and hospitals with high rates of C. diff are fined, said study co-author Tim Peto of the University of Oxford. The study results suggest that preventive steps, like hand washing and isolation of infected patients, may only address about a quarter of C. diff infections in some hospitals.

In order to trace the connections between infected hospital patients, the researchers focused on Oxfordshire, a county with a population of about 600,000 in the UK, where almost all health care is provided by one hospital system, which relies on one lab to run diagnostic tests for C. difficile.  Over the course of two and half years, samples from all patients with diarrhea, and most patients over 65, were sent to this central facility. Hospitals as well as general practitioners sent samples. The researchers also had access to data on patient locations and movements. Stool samples were screened for C. diff toxins, positive samples were cultured, and the isolates genotyped based on several loci.

Genotyping allowed Peto and his colleagues to trace the path of specific strains, and the hospital ward data gave insight into possible instances of contact between patients. Although rates of infection varied by specialty (oncology vs. general surgery, for example), only a quarter of cases could be traced back to a known infected patient.

Peto said he suspects that instead of encountering C. diff upon entering the hospital, most patients who fell ill carried it in with them. Then, poor health and antibiotic treatment combined to encourage C. diff to overrun the intestines and cause disease. “You blame the hospital,” Peto explained, “but that’s were you go when you’re ill.”

It’s the inability to ascertain the relative impact of asymptomatic carriers that worries Louis Valiquette, an epidemiologist at Université de Sherbrooke in Quebec who did not participate in the study. In healthy adults, only about 3-5 percent will have C. diff in their stool, Valiquette explained, but that rate jumps to more than 40 percent in people who have contact with hospital environments. Though he agreed that the study’s scope and felt the results were impressive, Valiquette said that the data is limited by the standard of preventive practices used in the surveyed hospitals. It’s unclear, Valiquette said, whether the results could be replicated in hospitals with different practices.

Even if only 25 percent of C. diff infections are acquired inside the hospital, it’s a worrisome rate, and doesn’t argue against stringent control measures, added Valiquette.

In contrast, Sepkowitz sees in the results a recommendation for restraint. Most C. diff cases are associated with antibiotic treatment, meaning that regardless of the route of acquisition, disease might be avoided with more judicious use of the drugs.

Peto’s team is now performing whole genome sequencing of C. diff strains and focusing on community acquired C. difficile infection.

Much about C. diff infection and epidemiology is unknown, said Peto. The hypervirulent strain, O27, which was most prevalent at the study’s inception, almost never pops up anymore, Peto said. Whether C. diff mutated away from virulence, or new, less-virulent strains replaced O27, is unclear. Whole genome sequencing will also help researchers hoping to identify virulence-conferring mutations. Sepkowitz hopes that future research brings a deeper understanding of C. diff biology, its incubation time and the “magic moment” when spores become viable.

A.S. Walker et al., “Characterisation of Clostridium difficile Hospital Ward–Based Transmission Using Extensive Epidemiological Data and Molecular Typing,” PLos Medicine, doi:10.1371/journal.pmed.1001172, 2012.

Posted in Articles | Tagged , , , , , | Leave a comment

HAI Laws and State Statutes as of Aug. 1, 2011

The following list of healthcare-associated infection (HAI) laws reflects state statutes and administrative regulations as of August 1, 2011.  The list will be updated periodically to reflect current changes in HAI laws.

This information is provided as a reference companion to an article published in the journal Infection Control and Hospital Epidemiology:  J. Reagan and C. Hacker.  Laws Pertaining to Healthcare-Associated Infections: A Review of 3 Legal Requirements.  Infection Control and Hospital Epidemiology, Vol. 33, No. 1: 75-80 (January 2012).

Updated as of August 1, 2011.

State Are data submission requirements mandatory or voluntary? Does the state HAI law have public reporting provisions? Are facility identifiers required to be included in public reports?
AL MANDATORYAla. Code § 22-11A-114(a) (hospitals required to report data on facility acquired infections). YESAla. Code § 22-11A-117 (department may undertake studies and publish information based on data obtained). YESAla. Code § 22-11A-117 (one of the purposes of studies is to “provide specific comparative health care facility” HAI rates).
AK N/A (No HAI law)S.J. Res. No. 19 (2006) (study law only). N/A N/A
AZ N/A (No HAI law)S.B. No. 1356 (2008) (study law only). N/A N/A
AR VOLUNTARYHowever, MANDATORY data submission is required for facilities participating in the CMS Hospital Inpatient Quality Reporting Program.Ark. Code Ann. § 20-9-1203(a) (health facilities “shall collect data” on HAI rates); § 20-9-1203(b) (health facilities “may voluntarily submit quarterly reports” on HAI rates to the Department of Health;  § 20-9-1203(c) (health facilities participating in the CMS Hospital Inpatient Quality Reporting Program “shall authorize the department to have access to” certain information submitted to NHSN). YESArk. Code Ann. § 20-9-1205 (requires annual report summarizing health facility quarterly reports to be published on department’s website and made available on request). NOArk. Code Ann. § 20-9-1205(a)(1)(B)  (“No health facility-identifiable data shall be included in the annual report, but aggregate statistical data may be included.”); § 1205(f) (“No annual report or other department disclosure shall contain information that identifies or could be used to identify a specific health facility.”).
CA MANDATORYCal. Health & Safety Code § 1288.55(a) (health facilities “shall report” certain HAIs). YESCal. Health & Safety Code § 1288.55(b) (HAI incidence rates shall be posted on department’s website). YESCal. Health & Safety Code § 1288.55(b) (department shall post on website information regarding incidence rate of HAIs acquired at each facility).
CO MANDATORYColo. Rev. Stat. § 25-3-602(1)(a), (3)(a) (health facilities shall collect and shall submit HAI data). YESColo. Rev. Stat. § 25-3-603(1)-(3) (department shall submit annual report to state legislature, post report on website, issue semi-annual bulletins, and publicize the report as widely as practical).

Click here to view Colorado’s January 2012 Annual Report

YESColo. Rev. Stat. § 25-3-603(3)(b) (annual report shall compare HAI rates for each individual health facility in the state).
CT MANDATORYConn. Gen. Stat. § 19a-490o(a) (department shall implement the recommendation of HAI committee “with respect to the establishment of a “mandatory reporting system” for HAIs). YESConn. Gen. Stat. § 19a-490o(c) (annual report shall be submitted to the legislature, posted on department’s website and made available to the public). LAW IS SILENT
DE MANDATORYDel. Code Ann. tit 16 § 1003A(b)(1)  (infection control professionals of hospitals shall submit quarterly reports on HAI rates). YESDel. Code Ann. tit 16 §1004A(a) (annual report shall be submitted to legislature and published on department’s website). YESDel. Code Ann. tit 16 § 1004A(c) (annual report “shall compare” HAI rates to national rates for each individual hospital in the state).
DC MANDATORYD.C. Code Ann. § 7-161(d) (mandatory adverse event reporting by healthcare providers and medical facilities); D.C. Mun. Regs. tit 22, § B208.1 (“Each healthcare facility shall report the aggregate number of patients with MRSA bloodstream infections.”). YESD.C. Code Ann. § 7-161(c)(8) (annual report shall be published including “summary data of the number and types of adverse events.”). NO — SUMMARY ONLYD.C. Code Ann. § 7-161(c)(8) (published annual report is to include summary data by “type of healthcare providers and medical facility”).
FL MANDATORYFla. Stat. § 408.061(1)(a) (data submission by health care facilities on HAIs shall be required). YESFla. Stat. § 408.063(2) (information shall be published and disseminated to the public). OPTIONALFla. Stat. § 408.063(2) (information shall be published in a manner “which will enhance informed decisionmaking in the selection of health care providers, facilities, and services.  Such publications may identify [certain aspects] for selection and use of health care providers, health care facilities, and health care services and such other information as the agency deems appropriate.”).
GA N/A (No HAI law)S. Res. no. 22 (2006) (study law only). N/A N/A
HI MANDATORYH. B. No. 889, section 2 (2011).  Note, mandatory data submission requirements applicable only to CMS certified facilities only.  (“Each health care facility in the State that is certified by the Centers for Medicare and Medicaid Services shall report information about health care-associated infections to the Centers for Disease Control and Prevention’s national healthcare safety network ….”). YESH. B. No. 889, section 2(e) (2011) (“The department may issue reports to the public regarding health care-associated infections in aggregate data form to protect individual patient identity.”). OPTIONALH. B. No. 889, section 2(e) (2011) (Reports issued by the department “may identify individual health care facilities.”).
ID N/A (No HAI law) N/A N/A
IL MANDATORY210 Ill. Comp. Stat. § 86/25(d) (requires submission of quarterly and annual reports by hospitals). YES210 Ill. Comp. Stat.§ 86/30  (department shall submit annual report to legislature and publish on its website). YES210 Ill. Comp. Stat. § 86/30 (department shall publish risk-adjusted mortality rates for each hospital); § 86/25(c) (describing required process for public disclosure of comparative hospital information).
IN N/A (No HAI law)Ind. Code Ann. §§ 16-40-5-1 to 16-40-5-8 (study law; expired June 20, 2010). N/A N/A
IA N/A (No HAI law) N/A N/A
KS N/A (No HAI law) N/A N/A
KY N/A (No HAI law) N/A N/A
LA N/A (No HAI law) N/A N/A
ME MANDATORYMe. Rev. Stat. Ann. tit. 22 § 8753 (health care facility shall notify division when sentinel event has occurred); 90-590-270 Me. Code R. § 3(A) (each hospital shall report HAI quality metrics data). YESMaine Rev. Stat. Ann. tit. 24A § 6951(4) (annual quality reports shall be produced; reports to be made available on publicly accessible website); Me. Rev. Stat. Ann. tit. 22 § 8707 (public access to data); Me. Rev. Stat. Ann. tit. 22 § 8712 (Maine Health Data Organization “shall distribute the reports on a publicly accessible site on the Internet or via mail or e-mail….”); 90-590-120 Me. Code R. (chapter provides for public disclosure of submitted data). YESMaine Rev. Stat. Ann. tit. 24A § 6951(4) (Maine Quality Forum  annual quality reports shall include provider-specific information); Maine Rev. Stat. tit. 22 § 8712(3) (annual report shall compare most common diagnosis-related groups and outpatient procedures for all hospitals in the state).
MD MANDATORYMd. Code Regs. 10.25.04.02(A) (each hospital shall file data on HAI measures). YESMd. Code Ann., Health-General § 19-134(e) (commission may annually publish comparative evaluation of quality of care outcomes and performance measurements of hospitals and ambulatory surgical facilities); Md. Code Regs. 10.25.04.03(A) (summary studies, reports, or other compilations of data submitted are public information); Md. Code Regs. 10.25.04.03(C) (commission shall publish annual results of quality and performance evaluation system). YESMd. Code Ann., Health-General § 19-134(e) (annual report is comparative evaluation); Md. Code Regs. 10.25.04.03(C) (annual reports shall be published on a comparative basis and may compare hospital performance to federal public health goals).
MA MANDATORYMass. Ann. Laws ch. 111, § 51H(b) (facilities “shall report” data and information about HAIs); Mass. Code Regs. § 130.1701(B)-(C) (each hospital shall collect and submit data); § 140.309(B)(2) (ambulatory surgery centers shall collect and submit HAI data). YESMass. Ann. Laws ch. 111, § 51H(c) (department shall transmit data collected for publication on consumer health information website). LAW IS SILENT
MI N/A (No HAI law)See however, Mich. Admin. Code r. § 325.172, Rule 2(dddd) (communicable and related diseases rules; “The unusual occurrence, outbreak, or epidemic of any condition, including healthcare-associated infections” is reportable).  N/A N/A
MN MANDATORYMinn. Stat. § 62J.82(Subd. 1)(2) (Minnesota Hospital Association shall develop web-based system for reporting HAI measures); § 62J.82(Subd. 3) (if hospital does not report measures, commissioner of health may bring enforcement action). YESMinn. Stat. § 62J.82(Subd. 1) – (Subd. 2) (web-based system for reporting HAI measures available to the public). YESMinn. Stat. § 62J.82(Subd. 2) (web site to provide comparative hospital-specific data on HAI public reporting measures).
MS N/A (No HAI law) N/A N/A
MO MANDATORYMo. Ann. Stat. § 192.667(2) (“Hospitals, ambulatory surgical centers, and other facilities shall provide data on required nosocomial infection incidence rates ….”). YESMo. Ann. Stat. § 192.667(8) (“department shall undertake a reasonable number of studies and publish information, including at least an annual consumer guide ….”). YESMo. Ann. Stat. § 192.667(12) (public report shall show nosocomial infection incidence rate for each hospital, ambulatory surgical center, and other facility).
MT N/A (No HAI law) N/A N/A
NE N/A (No HAI law)However, providers are required to submit data to a state patient safety organization, not to the Nebraska Department of Health and Human Services.Neb. Rev. Stat. § 71-8717(1)(j) (providers subject to Patient Safety Improvement Act shall report “unanticipated death or major permanent loss of function associated with health care associated nosocomial infection.”); § 71-8714 (data submission is made to a patient safety organization). N/A N/A
NV MANDATORYNev. Rev. Stat. Ann. § 439.835 (mandatory reporting of sentinel events); § 439.802 (defines facility acquired infections to be reported). YESNev. Rev. Stat. Ann. § 439.840(1)(d) (health division shall prepare annual summary of reports; inclusion on website).Nev. Rev. Stat. § 439A.270(1)(g) (summary report of sentinel events to be included on internet website established for information concerning hospitals and surgical centers for ambulatory patients).*New S.B. 209 (2011) (Health Division shall prepare annual report for inclusion in Internet website). YES *New     S.B. 209 (2011), effective prior to October 2011.Note: Former Nev. Rev. Stat. Ann § 439.840(1)(d), (2) provided for summary reports only (health division shall prepare annual summary of reports for inclusion on website; original reports received shall remain confidential).S.B. 209 (2011), which is effective prior to October 2011 amended the law to provide that the annual report prepared by the Health Division “must be reported in a manner that allows a person to compare the information for medical facilities.”
NH MANDATORYN.H. Rev. Stat. Ann. § 151:33 (hospitals shall report infections). YESN.H. Rev. Stat. Ann. § 151:34(I) (“department shall establish statewide database of all reported infection information”). YESN.H. Rev. Stat. Ann. § 151:34(I) (database shall be organized to allow for comparison of individual hospitals).
NJ MANDATORYN.J. Stat. Ann. § 26:2H-12.41 (general hospitals shall be required to report to the department HAI process quality indicators and data on infection rates); N.J. Admin. Code § 8:56-2.4(b)(2) (submission of mandatory data elements required); § 8:56-2.6(a)  (each health care facility shall report HAI data). YESN.J. Stat. Ann. § 26:2H-12.43 (information shall be made available to public on internet website); N.J. Admin. Code § 8:56-3.1(b) (analysis of quality of care HAI data is to be made available to public). YESN.J. Stat. Ann. § 26:2H-12.43 (information made available to public on internet website pursuant to § 26:2H-12.43 is to be formatted to enable comparisons among hospitals); N.J. Admin. Code § 8:56-3.1(a) (“Department shall utilize procedures to allow appropriate comparison of the quality of care related to HAI across health care facilities ….”).
NM VOLUNTARYN.M. Stat. Ann. § 24-29-4(A) (requires recruitment of hospitals to participate in HAI surveillance on voluntary basis); § 24-29-6(A) (participating hospitals shall report the incidence of selected indicators).H.J. Mem. No. 67 (2007) (study law only). YESN.M. Stat. Ann. § 24-29-6(B) (reports shall be published periodically). LAW IS SILENTN.M. Stat. Ann. § 24-29-6(B) (advisory committee shall determine content of public reports).
NY MANDATORYN.Y. Public Health Law § 2819(2)(a) (General hospitals “shall maintain a program capable of identifying and tracking [HAIs]” for public reporting.”); § 2819(3) (hospitals “shall regularly report” HAI data). YESN.Y. Public Health Law § 2819(4) (commissioner “shall establish” a state-wide database of reported HAI information). YESN.Y. Public Health Law  § 2819(4) (state-wide “database shall be organized so that consumers, hospitals, healthcare professionals, purchasers and payers may compare individual hospital experience with that of other individual hospitals as well as regional and state-wide averages and, where available, national data.”).
NC MANDATORYH.B. 809 (2011), § 130A-150(c) (“Each hospital,” is subject to the statewide surveillance and reporting system established” … “and shall be responsible for health care-associated infections surveillance and reporting ….”). YESH.B. 809 (2011), § 130A-150(d) (“The department shall release to the public aggregated and provider-specific data on health care-associated infections ….”). YESH.B. 809 (2011), § 130A-150(c) (Department shall release to the public “provider-specific data ….”).
ND N/A (No HAI law)See however, N.D. Admin. Code 33-06-01-01(42) (reportable conditions rules; nosocomial outbreaks in institutions must be reported). N/A N/A
OH MANDATORYOhio Rev. Code Ann. § 3727.33 (“each hospital shall submit information” showing hospital performance in meeting measures specified under §  3727.41); § 3727.41(A)(1) (director of health shall adopt rules governing hospitals in submission of information under § 3727.33); § 3727.41(B)(1) (rules for submission of information under 3727.33 shall include rules specifying inpatient and outpatient services measures to be used by hospitals); Ohio Admin. Code 3701-14-01 to 3701-14-04 (HAI indicators to be reported listed in DRG reporting requirement rules). YESOhio Rev. Code Ann. § 3727.39(B) (“director shall make submitted information available on an internet” website that is available to the public). YESOhio Rev. Code Ann. § 3727.39(C) (info presented on website “shall be presented” in manner that enables public to compare performance of hospitals in meeting the measures).
OK MANDATORYOkla. Stat. tit. 63, § 1-707(C)(2)(c) (advisory council shall have duty and authority to recommend and approve indicators and data submission requirements for hospitals); Okla. Admin. Code § 310:667-1-3(i)(2) (data submission requirements; each hospital “shall report applicable data” to the department). YESOkla. Stat. tit. 63, § 1-707(C)(2)(d) (advisory council shall have duty to publish annual report of hospital performance). YESOkla. Stat. tit. 63, § 1-707(C)(2)(d) (annual report to include the facility specific quality indicators).
OR MANDATORYOr. Rev. Stat. § 442.851, note, section 3(2)(a) (HAI program shall adopt rules to require health care facilities to report HAI measures); Or. Admin. R. 409-023-0010 (hospitals shall collect and report HAI data). YESOr. Rev. Stat. § 409.851, note, section 3(6) (rules for public disclosure of reported HAI measures shall be adopted); § 442.851, note, section 6(1), (4) (annual report summarizing health care facility reports submitted shall be prepared; shall be publicized to interested persons). YESOr. Rev. Stat. § 442.851, note, section 6(2) (annual report shall compare HAI measures for each health care facility in the state).
PA MANDATORY40 Pa. Stat. Ann. § 1303.404(b) (hospitals shall report HAI data). YES40 Pa. Stat. Ann. § 1303.304(c)(1), (3) (annual report shall be made available for public inspection and posted on website) YES40 Pa. Stat. Ann. § 1303.304(c)(1)(iv) (annual report shall include the “number of serious events and incidents reported by medical facilities on a geographical basis”).
PR N/A (No HAI law)However, see Laws of Puerto Rico Ann. § 363 (requires notification of nosocomial infections occurring at Puerto Rico health facilities). N/A N/A
RI MANDATORYR.I. Gen. Laws § 23-17.17-6(a)(9)(ii)(a) (individual hospitals shall collect data on HAIs). YESR.I. Gen. Laws § 23-17.17-5(b) (director shall prepare statewide quality performance measure report using data collected; shall be made available to the public). YESR.I. Gen. Laws § 23-17.17-5(b) (quality performance measurement report based on data collected shall be made available to the public to show how individual facilities compare).
SC MANDATORYS.C. Code Ann. § 44-7-2430(A)-(B) (individual hospitals shall collect data and shall submit reports on HAI rates to the department). YESS.C. Code Ann. § 44-7-2440(A) (annual report to be submitted to legislature and published on department website). YESS.C. Code Ann. § 44-7-2440(C) (annual reports must compare HAI rates for each individual hospital in the state).
SD N/A (No HAI law)See however, S.D. Admin. R.  44:20:01:01(31) (communicable disease rules; nosocomial infections are reportable). N/A N/A
TN MANDATORYTenn. Code Ann. § 68-11-263(a) (facilities shall join NHSN and submit data). YESTenn. Code Ann. § 68-11-263(b)(2) (department shall post information received from NHSN on department’s web site for public review). OPTIONALTenn. Code Ann. § 68-11-265 (reports and studies prepared by the department may identify individual healthcare entities).
TX MANDATORYTex. Health & Safety Code Ann. § 98.103 (health care facilities “shall report” certain infections). YESTex. Health & Safety Code Ann. §  98.106(a) (department shall make public summary available). YESTex. Health & Safety Code Ann. §  98.106(b) (public summary must include comparison of infection rates for each health care facility in the state).
UT MANDATORYUtah Admin. Code r. §  R386-705-3 (with certain exceptions, all hospitals shall report certain HAIs). NO N/A
VT MANDATORYVt. Stat. Ann. tit. 18, § 9405b(a)(3) (commissioner shall adopt rules establishing standard format for community reports which shall include measures of HAIs); § 9405b(b) (each hospital shall publish its community report on its website and make paper copies available); 21-040-026 Vt. Code R. § 2(A) (each hospital responsible for publishing community report and making available to commissioner). YESVt. Stat. Ann. tit. 18, § 9405b(c) (Commissioner shall publish community reports provided by hospitals on a public website). YESVt. Stat. Ann. tit. 18, § 9405b(c) (commissioner’s published reports on public website shall include a comparisons of hospitals within same categories of quality and financial indicators).
VA MANDATORYVa. Code.  Ann.  § 32.1-35.1 (acute care hospitals shall report information about nosocomial infections); 12 Va. Admin. Code § 5-90-370(B) (acute care hospitals shall collect and submit data). YESVa. Code.  Ann.  § 32.1-35.1 (hospital infection rate data is public information that may be released);12 Va. Admin. Code § 5-90-370(C) (infection rate data is releasable upon request). LAW IS SILENT
WA MANDATORYWash. Rev. Code § 43.70.056(2)(a) (hospitals shall collect and submit HAI data). YESWash. Rev. Code § 43.70.056(2)(b)(ii)(B)  (Washington state hospital association must develop report and publish on its web site). YESWash. Rev. Code § 43.70.056(2)(b)(ii)(B) (public report must compare HAI rates for individual hospitals).
WV MANDATORYW. Va. Code § 16-5B-17(d) (hospitals shall report information on HAIs). YESW. Va. Code § 16-5B-17(f) (results of collection and analysis of all hospital data shall be provided for public availability). LAW IS SILENT
WI N/A (No HAI law) N/A N/A
WY N/A (No HAI law) N/A N/A
Posted in Articles | Tagged , , , , , | Leave a comment

What Do Hand-Washing and Financial Illiteracy Have in Common? A New Freakonomics Radio Podcast

Freakonomics has a new pod-cast out on Hand Washing and the issues surrounding hand hygiene and compliance to hand hygiene protocols in hospitals.

Visit their site at:

http://www.freakonomics.com/2012/01/19/what-do-hand-washing-and-financial-illiteracy-have-in-common-a-new-freakonomics-radio-podcast/

Posted in Articles | Tagged , , | Leave a comment

Healthcare Associated Infections Targeted in 2011 and 2012 Legislation

A December 28, 2011 article in USA Today listed out the big changes in healthcare for 2011, including changes geared to lower healthcare associated infections.

Oct. 1, Value-based purchasing in Medicare: Hospitals will receive financial incentives to improve the quality of care and will be required to report publicly their data relating to heart attacks, heart failure, pneumonia, surgical care, health care associated infections and patients’ perception of care.”

According to the article, Americans will see several more changes in 2012: Insurance companies must pay rebates to consumers when they spend more than 80% of deductibles on anything besides health care. Providers will form Affordable Care Organizations based around keeping patients healthy, rather than being paid by how many tests or surgeries they perform. And hospitals will be required to publicly release quality data that show how they do with heart attacks, heart failure, pneumonia, surgical care, health-care-associated infections and patient surveys.

To read more, CLICK HERE.

Posted in Articles | Tagged , , , , | Leave a comment