Gutting HAIs: Ambitious goals for 2020

The Department of Health and Human Services (HHS) has given hospitals aggressive goals on HAI reduction. By 2020, the department wants CAUTI rates to be cut 50% in acute care hospitals, long-term care facilities, and ambulatory surgical centers.

Sue Dill Calloway, RN, Esq., AD, BA, BSN, MSN, JD, CPHRM, CCMSCP, president of Patient Safety and Healthcare Consulting and Education, says the HHS goals are pretty ambitious, particularly considering some of their previous results.

The first step, Calloway says, is for hospitals to commit to HAI prevention training. That requires special emphasis on educating staff working on the frontlines of care.

“When my sister was in [the hospital], I saw [staff] do some really bad dressing changes,” she says. “I saw them not washing their hands. When my sister had a wound infection, they didn’t culture it or notify the infection preventionist. They took an off-label saline flush and put it on there. And there was a fresh patient coming from postop into that room.”

HAI training requires many different competencies, she says, including hand hygiene, proper antibiotic usage, and the correct way of handling IVs and catheters. While conducting this kind of training may sound like a drain on resources, she points to a number of free toolkits and resources that organizations can take advantage of. Two key providers of free HAI prevention guidance and training are the Centers for Disease Control and Prevention (CDC) and the Institute for Healthcare Improvement (IHI). The CDC website offers several worksheets, checklists, and free webinars on HAI reduction and antimicrobial stewardship. Meanwhile, the IHI has several HAI reduction toolkits and how-to guides covering hand washing, CAUTIs, SSI, CLABSI, and MRSA. 

The main issue with these resources, she says, is that most people aren’t aware that they exist.

“The CDC in April 2011 put out this amazing document on reducing infections and found a lot of hospitals didn’t even use it,” says Calloway. “It was a great resource that tells you how to put a peripheral line, mid-line, central line. It told you how often to change the dressing, how often to change the tubing. But I did a number of web-based programs—none of them were well attended—and we would ask people, ‘Do you know this document? Do you use this document?’ They would say, ‘No.’ ”

She says this lack of awareness of HAI resources has even come to the attention of CMS, who even mentioned in its list of proposed changes that many outpatient facilities were unaware that there was a CDC infection control checklist for them.

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