About Healthcare Associated Infections (HAIs)
  • An estimated 5 percent of all hospital admissions result in infections that patients acquire while receiving treatment for other conditions.
    • HAIs now affect one in 25 healthcare patients.
    • HAIs result in 99,000 deaths each year or 271 deaths per day.¹
  • HAIs are caused by viral, bacterial and fungal pathogens; the most common types are:
    • Bloodstream infection (BSI)
    • Pneumonia (e.g., ventilator-associated pneumonia [VAP])
    • Urinary tract infection (UTI)
    • Surgical site infection (SSI)
  • HAIs can be acquired anywhere healthcare is delivered, including:
    • Inpatient acute care hospitals
    • Outpatient settings (e.g. ambulatory surgical centers and end-stage renal disease facilities)
    • Long-term care facilities (e.g. nursing homes and rehabilitation centers)
  • Airborne generated infections make up approximately 17 -22 percent of HAIs.
    • Studies have shown that more than half of the HAIs related to Aspergillus infections are caused by construction related activities in hospitals.
      • Since half Aspergillus infections are caused by construction and maintenance activities, training all the outside vendors that come into hospitals to work is critical and recommended by CDC.
      • ICU targets elevator technicians, IT professionals, painters, electricians, etc. These vendors need Infection Control Awareness training to make healthcare facilities safer and to reduce HAIs.

 

2011
Major Site of Infection Estimated No.
Pneumonia 157,500
Gastrointestinal Illness 123,100
Urinary Tract Infections 93,300
Primary Bloodstream Infections 71,900
Surgical site infections from any inpatient surgery 157,500
Other types of infections 118,500
Estimated total number of infections in hospitals 721,800

 

2012
Type of Healthcare-Associated Infection Estimated No.
Catheter-associated urinary tract infections 
(wards and critical care units) 54,500 in 2012
Central line-associated bloodstream infections
 (wards and critical care units) 30,100 in 2012
Surgical Site Infections associated with 
10 surgical procedures 53,700 in 2012
Hospital-onset Clostridium difficile infections 
(all hospital locations) 107,700 in 2011

 

  • In 2011, the CDC estimated 722,000 patients contracted an infection during a stay in an acute care hospital in the U.S. More than half of all HAIs occurred outside of an intensive care unit.
  • Under the ACA, hospitals are penalized for having high infection rates. Recently, 30 hospitals in Florida were fined in excess of $300 million.
  • ACA citations for high infection rates cut critical reimbursement revenue.
  • HAIs cost hospitals more than $30.5 billion annually. Years ago, health insurers and Medicare paid the bulk of the cost, but now cost is being shifted to hospitals and facilities in the form of changes in reimbursement policies. Hospitals are now being scored based on items including patient satisfaction (HCAHPS) and the infection rate. These scores directly impact reimbursement to the tune of millions of dollars per facility.
  • The CDC states that hospitals are to provide education on infection control to all construction workers and staff.²
How are HAIs tracked?
  • Healthcare facilities report infections directly to CDC’s National Healthcare Safety Network (NHSN).
  • The standardized infection ratio (SIR) is a statistic used to track healthcare-associated infection prevention progress over time. The SIR for a facility or state is adjusted to account for factors that might cause infection rates to be higher or lower, such as hospital size, teaching status, low-income patients a hospital serves and surgery and patient characteristics.

Types of HAIs include:

  • Central Line-Associated Bloodstream Infections (CLABSIs): A central line is a tube that a doctor usually places in a large vein of a patient’s neck or chest to give important medical treatment. When not put in correctly or kept clean, central lines can become a freeway for germs to enter the body and cause deadly infections in the blood.
  • Catheter-Associated Urinary Tract Infections (CAUTIs): When a urinary catheter is not inserted correctly, not kept clean or left in a patient for too long, germs can travel through the catheter and cause a catheter-associated urinary tract infection in the urinary system, which includes the bladder and kidneys.
  • Surgical Site Infections (SSIs) – Colon Surgery and Abdominal Hysterectomy Surgery: When germs get into an area where surgery is or was performed, patients can get a surgical site infection. Sometimes these infections involve the skin only. Other SSIs can involve tissues under the skin, organs or implanted material.
About HAIs Readmission Rates
  • In 2015, Medicare is fining 2,610 hospitals for high admission rates, which is an increase of 433 hospitals over last year in 2014.
  • About 20 percent of Medicare patients are readmitted within a month, costing $17.4 billion annually.³
  • Hospitals that were penalized in 2013 receive lower payments for every Medicare patient from Oct. 1 through Sept. 30, 2015.⁴
  • Fines will total around $428 million based on readmissions from July 2010 through June 2013.
  • Penalties in 2014 are harsher than last year– hospitals with the highest readmission rates will lose 3 percent of each payment (last year’s rate was a 2 percent loss).
    • 39 hospitals will have their payments lowered by 3 percent (this includes: specialty surgical hospitals, small community hospitals and major teaching hospitals).
  • A contributing factor to the increased number of penalties is Medicare’s addition of two readmission categories:
    • Patients undergoing elective hip or knee replacements
    • Patients with chronic obstructive pulmonary disease
  • In order to have the best payoff for hospitals and patients, healthcare facilities should be preventing infections before they occur.
  • HAIs, even when treated successfully, impact direct cost and length of hospital stay.⁵
  • Preventing HAIs associated with indwelling medical devices hold promise for saving lives and reducing hospitalization cost.⁵
About Infection Disease Crisis
  • Infectious diseases kill more people worldwide than any other single cause.⁶
  • Infectious diseases are caused by germs. Germs are spread through touching, eating, drinking or breathing. Germs can also spread through animal and insect bites, kissing and sexual contact.⁶
  • There are four main kinds of germs:
    • Bacteria – one-celled germs that multiply quickly and may release chemicals that can cause illness
    • Viruses – capsules that contain genetic material and use a body’s cells to multiply
    • Fungi – primitive plants, such as mushrooms or mildew
    • Protozoa – one-celled animals that use other living things for food and a place to live

The following are the latest statistics available:⁷

  • Hepatitis A: The CDC estimates that 2,700 new cases of Hepatitis A occurred in the U.S. in 2011.
  • Hepatitis B: In the U.S., it is estimated that 700,000 to 1.4 million people have chronic hepatitis B infections. It is estimated that in 2011, 19,000 new cases occurred in the U.S.
  • Hepatitis C: In the U.S., it is estimated that between 2.5 million and 3.9 million people have chronic hepatitis C infections. It is estimated that in 2011, about 17,000 new cases occurred in the U.S.
  • Tuberculosis: TB has infected one-third of the world’s population. In 2012, nearly 10,000 new cases were reported in the U.S.
  • Influenza/Pneumonia: About 36,000 people per year in the U.S. die from influenza and pneumonia.
  • HIV: Roughly 50,000 new cases of HIV infections occur annually in the U.S., and nearly 33 million people are infected with HIV in the world.⁸
  • Chickenpox Vaccine: The chickenpox vaccine has decreased the frequency of new cases of chickenpox in all age groups, especially in children ages 1 to 4 years.
  • Measles Vaccine: Even though the measles vaccine is now available, in 2013 there were nearly 200 new cases of measles (rubeola) in the U.S. Measles outbreaks in 2014 increased the rate of new cases.
  • STDs: The number of new cases of sexually transmitted diseases reported in the U.S. in 2007 include:
    • Syphilis (primary and secondary): more than 11,000
    • Chlamydia: 1,108,000
    • Gonorrhea: 356,000
  • Whooping Cough: Whooping Cough affects 5,000 to 7,000 people in the U.S. annually. In 2007, about 17,000 new cases were reported to the CDC, including 14 deaths nationally. Initial 2010 data shows more than 21,000 cases and 26 deaths – 22 of them in children less than 1 year of age.
References