ICUs must combat HAIs with updated staffing guidelines

Hospitals don't have proper staffing and guidelines to prevent common hospital acquired infections (HAI), especially catheter-associated urinary tract infections (CAUTI), according to a new study in the American Journal of Infection Control.

The survey-based study examined 975 responses to questions about infection prevention and control programs, as well as clinician compliance with programs to prevent HAIs in 1,653 intensive care units. 

Researchers, led by Patricia W. Stone, Ph.D., of Columbia University School of Nursing in New York City, found that few hospitals had prevention policies in place for CAUTIs, even though they are the most common HAI. Twenty-seven percent had policies in place to prevent nurse-initiated urinary catheterization and 68 percent had prevention policies for portable bladder ultrasounds. Adherence to prevention policies was even lower, ranging from 6 to 27 percent, according to the study.

However, prevention policies for central line-associated bloodstream infection (CLABSI) were common, with 87 to 97 percent applying chlorhexidine at catheter- insertion sites, but adherence only ranged from 37 percent to 71 percent. Sixty-nine percent to 91 percent of hospitals had ventilator-associated pneumonia prevention policies, but adherence to those policies only ranged from 45 percent to 55 percent.

"Unfortunately, the hospitals that monitored clinician adherence reported relatively low rates of adherence," the authors wrote.

The average number of infection preventionists (IPs) per 100 beds was 1.2. IP staff certifications varied by hospital and although the average hours a week devoted to data management and secretarial support were low, there were no differences in HAI rates between respondent and nonrespondent hospitals, according to the data.

Researchers concluded that acute care hospitals need to update their IP staffing guidelines in order to prevent HAIs.

HAIs cost $9.8 billion per year, with surgical site infections alone accounting for one-third of those costs, followed closely by ventilator-associated pneumonia at 31.6 percent, FierceHealthcare previously reported.

To learn more:
- here's the report

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