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“These reports provide the most detailed picture yet of health care-associated infections in California's hospitals,” CDPH Director, Dr. Ron Chapman said. "The information in these reports is intended to increase awareness and lead to appropriate changes that will decrease the number of these infections."
The collecting and reporting of data on health care-associated infections (HAI) enables hospitals to identify areas for improvement, health care purchasers to determine the value of care and patients to make more informed choices.
“Changes that are made to improve quality of care as a result of these data will potentially save hundreds of lives in California each year,” Dr. Chapman continued.
The reports provide data from California's hospitals for the following types of infections: Central-line associated bloodstream infections (CLABSI); Clostridium difficile infections (CDI); Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE) bloodstream infections; Surgical site infections (SSI).
A fifth report examines hospital use of practices to prevent specific infections, known as central-line insertion practices (CLIP), and a final report provides rates of influenza vaccination among hospital workers.
Highlights from the reports include:
Central-line associated bloodstream infections (CLABSI)—Half of all hospitals providing critical care to infants reported none of the infections in those patient care locations. This year’s report is the first in California to provide CLABSI rates for specific patient care locations within hospitals.
Clostridium difficile infections (CDI)—Long-term acute care hospitals have infection rates that are more than twice those of general acute care hospitals, most likely because patients stay longer in long-term care facilities.
Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE)—Forty-nine percent of the hospitals reported no MRSA and 59 percent reported no VRE. These infections occur primarily in severely ill patients. Rates of MRSA and VRE were significantly higher in major teaching and long-term acute care hospitals, where more severely ill patients receive care, than in pediatric hospitals and community hospitals.
Central-line insertion practices (CLIP)—In 93 percent of the instances in which these infection prevention practices were required, hospital staff did so.
California hospitals are now required to report Surgical Site Infection data electronically through the federal National Healthcare Safety Network (NHSN), effective April 1, 2011.
A smaller report using NHSN data, covering April through June, 2011, was included in those released Friday.
Data on health care worker vaccination practices, which was released in December 2011, show that the influenza vaccination rate for hospital employees was 64.3 percent in 2010-11, a slight increase from the rate of 62.6 percent in 2009-10.
In all of the reports but one – health care worker vaccination – hospitals used the NHSN reporting system for the first time. In addition, the report on CLIP was the first of its kind.
The series of reports are mandated by SB 1058 (Chapter 296, Statues of 2008). Hospital compliance with providing data for the reports for 2010-11 ranged from 91 percent to 98 percent.
To promote compliance, CDPH conducts a quality assurance process that ensures that hospitals are aware of missing or unreported data, provides assistance in correcting deficiencies and offers educational opportunities and individual onsite consultation to assist hospitals in reporting compliance.
Hospitals are actively engaged in efforts to prevent HAI. One of the best examples, Dr. Chapman said, is the California Perinatal Quality Care Collaborative, an effort to protect the health of newborns.
Substantial numbers of hospitals reported no CLABSIs in their neonatal critical care units, which may be a reflection of this prevention initiative.
“These important and helpful reports continue the dialogue about the differences in infection rates in hospitals and how to reduce those rates,” Dr. Chapman added. “Consumers can ask their health care providers about health care-associated infections and measures to prevent them.”
The reports can be found at http://www.cdph.ca.gov/Pages/NR12-001.aspx.
