Oregon Hospitals Beat National Averages for Preventing Health Care-Associated Infections

10/05/16  Portland, Ore.

OHA report finds more work needed to cut deadly CLABSI, C. diff infections

Oregon hospitals are beating national averages for preventing most health care-associated infections, but they aren’t meeting targets for reducing a type of bloodstream infection and a potentially deadly bacterium known as Clostridium difficile, according to a new state report.

The “Health Care-Associated Infections: 2015 Oregon Annual Report,” published today by the Healthcare-Associated Infections Program at the Oregon Health Authority’s Public Health Division, examines data on health care-associated infections that Oregon hospitals were required to report to OHA in 2015.

The report contains HAI data for 61 individual hospitals and 60 freestanding dialysis facilities in Oregon. It has aggregate summaries and facility-specific data of Oregon hospital performances on 10 HAI metrics, with national benchmarks for comparison.

Overall, says Zintars Beldavs, Oregon HAI Program manager, hospitals are doing well in their efforts to fight infections acquired in hospital and other health care settings. But they still are falling short in some areas, with overuse and misuse of antibiotics, to which HAIs are becoming increasingly resistant, remaining a major hurdle.

“We need to do more to prevent HAIs, especially multidrug-resistant organisms, or MDROs,” Beldavs said. “The message here is people need to use antibiotics appropriately. Antibiotic resistance is one of the main drivers of C. difficile, which causes hundreds of thousands of infections and tens of thousands of deaths every year.”

C. difficile is a spore-forming bacterium that causes severe diarrhea, colon infection, sepsis and death. It spreads to patients from unclean hands and surfaces in hospitals. It’s one of several infections addressed in the report, including central line-associated bloodstream infections (CLABSI); catheter-associated urinary tract infections (CAUTI); methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, and surgical site infections (SSI).

HAIs occur during or after treatment for other medical conditions. HAIs are potentially life-threatening, and are preventable. About one in every 25 patients in the hospital will develop an HAI, according to the U.S. Department of Health and Human Services (HHS).

The Oregon HAI report found that in 2015, Oregon hospitals continued to reduce CLABSIs in adult and pediatric intensive care units (ICUs). They also performed well in the number off CAUTIs in both ICU and non-ICU ward settings compared to national performance.

Oregon hospitals also performed better on hospital-onset MRSA bloodstream infections compared to hospitals nationally. Oregon hospitals performed better in preventing surgical site infections following heart, hysterectomy, hip, and colon surgeries in 2015; in particular, surgical site infections following coronary artery bypass grafts was statistically better at Oregon hospitals than the national average and were quite lower than the 2014 national average. And Oregon dialysis facilities reported fewer bloodstream infections and fewer access-related bloodstream infections than the national average.

But Oregon hospitals in 2015 were unable to meet the national reduction targets for CLABSI in neonatal intensive care unit (NICU) and non-ICU ward settings. In additional, prevention of hospital-onset C. difficile infections worsened in Oregon hospitals in 2015.

Oregon hospitals’ performance also was not strong for laminectomy and knee surgeries, where the national reduction target for surgical site infections following knee surgeries was not met.

To address HAIs, OHA implements a mandatory HAI reporting program that raises awareness of HAIs, promotes transparency of health care information and helps hospitals reducing and prevent HAIs. The HAI Program supports numerous committees and networks working to detect and contain HAIs in Oregon. It also works to prevent spread of HAI outbreaks during patient transfers between health care facilities by encouraging communication between medical providers, and works to raise awareness among patients and health care providers about safe injection practices.

“We continue to seek new funding resources that will support expansion of our program that will lead to enhanced education and outreach efforts targeting the public and health care providers,” Beldavs said. “We can never over-communicate when it comes to HAIs.”

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