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Quality Measures pp 47–61Cite as

Infection Prevention Quality Metrics

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Abstract

Healthcare-associated infections cause patient suffering and excess healthcare costs. Infection prevention quality metrics are designed to reduce rates of healthcare-associated infections. Thanks to early pioneers in the field and solidified by evidence, infection prevention has transformed from a movement to a mandate. The Department of Health and Human Services (DHHS) National Action Plan seeks to improve patient safety and reduce healthcare costs by eliminating healthcare-associated infections. It sets goals for the reduction of central line–associated bloodstream infections, catheter-associated urinary tract infections, specific surgical site infections, methicillin-resistant Staphylococcus aureus bacteremia, and infections caused by Clostridioides difficile. Process and outcome measure data related to infections in acute care are provided to the Centers for Disease Control and Prevention via patient safety modules housed within the National Health and Safety Network, which in turn provides facilities, states, regions, and the nation with data intended to identify problem areas and measure the progress of prevention efforts to drive change. In addition to efforts to reduce the incidence of infection, diagnostic stewardship (limiting testing to patients suspected of having true infections) is critical to a successful infection prevention program. Healthcare-associated infection metrics are designed to reflect as accurately as possible the rates of infections acquired by hospitalized patients. Definitions are complex, and the administrative burden is significant. Successful performance improvement requires systems-focused interventions with forced functions.

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References

  1. HAI Data [Internet]. CDC.gov. 2018 [cited 1/22/19]. Available from: https://www.cdc.gov/hai/data/index.html.

  2. Currie K, Melone L, Stewart S, King C, Holopainen A, Clark A, et al. Understanding the patient experience of health care–associated infection: a qualitative systematic review. Am J Infect Control. 2018;46(8):936–42.

    Article  Google Scholar 

  3. Semmelweis I. Etiology, concept and prophylaxis of childbed fever. Madison: University of Wisconsin Press; 1983.

    Google Scholar 

  4. Dixon RE. Control of health-care-associated infections, 1961—2011. Morb Mortal Wkly Rep (MMWR). 2011;60:58–63.

    Google Scholar 

  5. Wise RI, Ossman EA, Littlefield DR. Personal reflections on nosocomial staphylococcal infections and the development of hospital surveillance. Med J Aust. 1978;12:543–6.

    Article  Google Scholar 

  6. Finland M, McGowan JE Jr. Nosocomial infections in surgical patients. Observations on effects of prophylactic antibiotics. Arch Surg. 1976;111:143–5.

    Article  CAS  Google Scholar 

  7. McGowan JE Jr, Barnes MW, Finland M. Bacteremia at Boston City Hospital: occurrence and mortality during 12 selected years (1935–1972), with special reference to hospital-acquired cases. J Infect Dis. 1975;132:316–35.

    Article  Google Scholar 

  8. Haley RW, Quade D, Freeman HE, et al. The SENIC project: study on the efficacy of nosocomial infection control (SENIC PROJECT): summary of study design. Am J Epidemiol. 1980;111:472–85.

    Article  CAS  Google Scholar 

  9. Haley RW, Culver DH, White JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol. 1985;121:182–205.

    Article  CAS  Google Scholar 

  10. Weinstein RA. Nosocomial infection update. Emerg Infect Dis. 1998;4:416–20.

    Article  CAS  Google Scholar 

  11. Berens M. Infection epidemic carves deadly path [Internet]. Chicago Tribune. 2002 [cited 22 January, 2019]. Available at: http://www.chicagotribune.com/news/chi-0207210272jul21-story.html.

  12. Institute of Medicine. To err is human: building a safer health system. Washington, DC: National Academies Press; 2000.

    Google Scholar 

  13. McKibben L, Horan T, Tokars JI. Guidance on public reporting of healthcare-associated infections: recommendations of the Healthcare Infection Control Practices Advisory Committee. Am J Infect Control. 2005;33:217–26.

    Article  Google Scholar 

  14. HHS Family of Agencies [Internet]. HHS.gov. 2016 [cited 24 January 2019]. Available from: https://www.hhs.gov/about/agencies/index.html.

  15. National Action Plan to prevent HAI: roadmap to elimination [Internet]. Health.gov. 2013 [cited 23 November 2018]. Available from: https://health.gov/hcq/pdfs/hai-action-plan-executive-summary.pdf.

  16. Longitudinal program evaluation of the HHS action plan to prevent healthcare-associated infections [Internet]. Health.gov. 2011 [cited 22 November 2018]. Available at https://health.gov/hcq/pdfs/hhs-action-plan-eval-report.pdf.

  17. Summary of progress toward the 2013 national targets for elimination of health care-associated infections [Internet]. Health.gov [cited 24 January 2019]. Available from: https://health.gov/hcq/prevent-hai-previous-targets.asp.

  18. The hospital value-based purchasing (VBP) program [Internet]. 2018 [cited 22 January 2019]. Available from: https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/HVBP/Hospital-Value-Based-Purchasing.html.

  19. Calderon L, Kavanagh K, Rice M. Questionable validity of the catheter-associated urinary tract infection metric used for value-based purchasing. Am J Infect Control. 2015;43(10):1050–2.

    Article  Google Scholar 

  20. 2016 national and state health-care associated infections report [Internet]. www.cdc.gov. 2018 [cited 20 January 2019]. Available from: https://www.cdc.gov/hai/data/portal/progress-report.html.

  21. Bartles R, Dickson A, Babade O. A systematic approach to quantifying infection prevention staffing and coverage needs. Am J Infect Control. 2018;46(5):487–91.

    Article  Google Scholar 

  22. Hazamy P, Van Antwerpen C, Tserenpuntsag B, Haley V, Tsivitis M, Doughty D, et al. Mandatory reporting of Hip replacement procedures: validating accuracy, New York State 2008. Am J Infect Control. 2010;38(5):E99.

    Google Scholar 

  23. Tsivitis M, Van Antwerpen C, Haley V, Tserenpuntsag B, Doughty D, Hazamy P. New York State Department of Health: mandatory public reporting – validation of CABG data. Am J Infect Control. 2011;39(5):E127.

    Google Scholar 

  24. Hazamy P, Van Antwerpen C, Tserenpuntsag B, Haley V, Tsivitis M, Doughty D, et al. Trends in validity of central line–associated bloodstream infection surveillance data, New York State, 2007–2010. Am J Infect Control. 2013;41(12):1200–4.

    Article  Google Scholar 

  25. Bagchi S, Watkins J, Pollock D, Edwards J, Allen-Bridson K. State health department validations of central line–associated bloodstream infection events reported via the National Healthcare Safety Network. Am J Infect Control. 2018;46(11):1290–5.

    Article  Google Scholar 

  26. Backman L, Carusillo E, D’aquila L, Melchreit R, Fekieta R. Validation of surgical site infection surveillance data in colon procedures reported to the Connecticut department of public health. Am J Infect Control. 2017;45(6):690–1.

    Article  Google Scholar 

  27. Levinson D. CMS validated hospital inpatient quality reporting program data but should use additional tools to identify gaming [Internet]. Oig.hhs.gov. 2017 [cited 18 January 2019]. Available from: https://oig.hhs.gov/oei/reports/oei-01-15-00320.pdf/.

  28. Madden GR, Weinstein RA, Sifri CD. Diagnostic stewardship for healthcare-associated infections: opportunities and challenges to safely reduce test use. Infect Control Hosp Epidemiol. 2018;39(2):214–8.

    Article  Google Scholar 

  29. Centers for Medicare and Medicaid Services. Medicare program: revisions to payment policies under the physician fee schedule and other revisions to Part B for CY 2016. Final rule with comment period. Fed Regist. 2015;80:70885–1386.

    Google Scholar 

  30. Morgan DJ, Malani P, Diekema DJ. Diagnostic stewardship leveraging the laboratory to improve antimicrobial use. JAMA. 2017;318:607–8.

    Article  Google Scholar 

  31. Durand DJ, Lewin JS, Berkowitz SA. Medical-imaging stewardship in the accountable care era. N Engl J Med. 2015;373(18):1691–3.

    Article  Google Scholar 

  32. McDonald EG, Saleh RR, Lee TC. Mindfulness-based laboratory reduction: reducing utilization through trainee-led daily ‘time outs. Am J Med. 2017;130:e241–4.

    Article  Google Scholar 

  33. CDC/NHSN surveillance definitions for specific types of infections [Internet]. CDC.gov. 2017 [cited 26 April 2017]. Available at: https://www.cdc.gov/nhsn/pdfs/pscmanual/17pscnosinfdef_ current.pdf.

  34. Cohen SH, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010;31:431–55.

    Article  Google Scholar 

  35. The NHSN standardized infection ratio (SIR): a guide to the SIR [Internet]. CDC.gov/NHSN. 2018 [cited 11 November 2018]. Available from: https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf.

  36. The targeted assessment for prevention (TAP) strategy: HAI: CDC [Internet]. CDC.gov/HAI. 2018. Available from: https://www.cdc.gov/hai/prevent/tap.html.

  37. Doron S, Nasraway S. The trouble with studying bundles. Crit Care Med. 2011;39(10):2355–7.

    Article  Google Scholar 

  38. Cafazzo J, St-Cyr O. From discovery to design: the evolution of human factors in healthcare. Healthc Q. 2012;15(sp):24–9.

    Article  Google Scholar 

  39. Henriksen K, Oppenheimer C. Envisioning patient safety in the year 2025: eight perspectives [Internet]. AHRQ.gov. ND. Available from: https://www.ahrq.gov/downloads/pub/advances2/vol1/Advances-Henriksen_104.pdf.

  40. Tracking infections in acute care hospitals/facilities | NHSN | CDC [Internet]. Cdc.gov. 2018 [cited 21 December 2018]. Available from: https://www.cdc.gov/nhsn/acute-care-hospital/index.html.

  41. Mu Y, Edwards J, Horan T, Berrios-Torres S, Fridkin S. Improving risk-adjusted measures of surgical site infection for the National Healthcare Safely Network. Infect Control Hosp Epidemiol. 2011;32(10):970–86.

    Article  Google Scholar 

  42. Hospital compare data [Internet]. Data.Medicare.gov. [cited 21 December 2018]. Available from: https://data.medicare.gov/data/hospital-compare.

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Author information

Authors and Affiliations

  1. Department of Infection Prevention, Tufts Medical Center, Boston, MA, USA

    Susanne Meninger & Karen Dowler

  2. Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA

    Hasan Fadlallah & Shira Doron

  3. Department of Quality and Patient Safety, Tufts Medical Center, Boston, MA, USA

    Karen Dowler

  4. Tufts Medical Center, Boston, MA, USA

    Shira Doron

Authors
  1. Susanne Meninger
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  2. Hasan Fadlallah
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  3. Karen Dowler
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  4. Shira Doron
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Corresponding author

Correspondence to Hasan Fadlallah .

Editor information

Editors and Affiliations

  1. Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA

    Deeb N. Salem

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Meninger, S., Fadlallah, H., Dowler, K., Doron, S. (2020). Infection Prevention Quality Metrics. In: Salem, D. (eds) Quality Measures. Springer, Cham. https://doi.org/10.1007/978-3-030-37145-6_4

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  • DOI: https://doi.org/10.1007/978-3-030-37145-6_4

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-37144-9

  • Online ISBN: 978-3-030-37145-6

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