According to the Centers for Disease Control and Prevention (CDC), on any given day, about one in 25 hospital patients has at least one healthcare-associated infection (HAI). The good news is that awareness and prevention strategies work to decrease HAI rates by more than 70 percent.
Besides the obvious health benefits, there is also a business case for stepping up enforcement to prevent HAIs, asserts regulatory compliance expert Sue Dill Calloway. The Centers for Medicare & Medicaid Services (CMS) recently issued a 49-page Hospital Infection Control Worksheet that surveyors are now using for all validation and certification surveys to determine compliance with the Infection Control Condition of Participation.
Hospitals that rank in the quartile of hospitals with the highest total Hospital-Acquired Condition (HAC) scores will have their CMS payments reduced by 1%, Calloway points out. In her audio conference for ProfEdOnDemand, “CMS Hospital Infection Control Worksheet: Proposed Changes and Antibiotic Stewardship Program,” she provides an in-depth understanding of the worksheet—as well as proposed changes for 2018, including the Antibiotic Stewardship Program.
Antibiotic Misuse: One Culprit To HAI
Overuse or improper use of antibiotics increases the risk of HAIs, according to health.gov.
The CDC states that 20-50 percent of all antibiotics prescribed in U.S. acute care hospitals are either unnecessary or inappropriate, leading to adverse drug reactions, Clostridium difficile (C. diff.) infection, and antibiotic resistance. To combat this, CMS mandates that all long-term healthcare facilities must implement Antibiotic Stewardship Programs (ASPs).
According to health.gov, ASPs have the potential to:
- Optimize clinical outcomes (such as infection treatment)
- Minimize unintended consequences
- Improve patient safety
- Improve cost effectiveness reducing inappropriate antibiotic use
The CDC states the core elements of Hospital ASPs should include:
- Leadership Commitment: Dedicate human, financial, and information technology resources.
- Accountability: Appoint a single leader (e.g., a physician) responsible for program outcomes.
- Drug Expertise: Appoint a single pharmacist leader responsible for improving antibiotic use.
- Action: Implement at least one recommended action, such as systemic evaluation of ongoing treatment need after a set period of initial treatment (i.e. “antibiotic time out” after 48 hours).
- Tracking: Monitor antibiotic prescribing and resistance patterns.
- Reporting: Regularly report information on antibiotic use and resistance to doctors, nurses, and relevant staff.
- Education: Teach clinicians about resistance and optimal prescribing.
Tip: In the Hospital Infection Control Worksheet, refer to Section 1.C. Systems to Prevent Transmission of MDROs and Promote Antimicrobial Stewardship to: see how surveyors evaluate antibiotic stewardship, assess your staff’s practices, and implement training to meet deficiencies.
Everyone Needs a Handwashing Reminder
Curbing antibiotic use is only one piece to the puzzle. Ask any grade school child how not to spread germs and they’ll probably tell you by washing your hands. Yet the CDC admits that on average, healthcare providers clean their hands less than half as frequently as they should.
The Joint Commission surveyed eight hospitals to ferret out the number one patient safety challenge. Guess what? Hand hygiene ranked number one.
Why, in an industry committed to preventing and curing illness, is this failure so prevalent? The Joint Commission Center for Transforming HealthcareProject uncovered ten main causes for failure to clean hands:
- Ineffective placement of dispensers or sinks
- Hand hygiene compliance data are not collected or reported accurately or frequently
- Lack of accountability and just‐in‐time coaching
- Safety culture does not stress hand hygiene at all levels
- Ineffective or insufficient education
- Hands full
- Wearing gloves interferes with process
- Perception that hand hygiene is not needed if wearing gloves
- Health care workers forget
- Distractions
Tip: Refer to Section 2.A. Hand Hygiene in the Hospital Infection Control Worksheet to see how surveyors evaluate hand hygiene practices, test your own staff’s hand-washing compliance, and figure out what training support you need going forward.
Get Infection Control Training
CMS’s Infection Control Worksheet is much more than just an assessment tool. It’s a standard your facility must live up to—or face fines.
And preventing hospital infections requires more than good handwashing. You need a multi-faceted awareness & prevention approach. In her webinar, Calloway digs into the worksheet’s details, outlines CMS requirements for safe injection practices and sharps safety, shares insight about the CDC’s vaccine storage and handling toolkit, and explains the CDC procedures for cleaning and disinfecting reusable medical devices.
