Infections acquired in healthcare settings — known as healthcare-associated infections (HAIs) — occur in 1 of every 25 patients.¹ HAIs extend treatment time and hospital stays as well as increase morbidity and mortality levels. In addition to these adverse patient care effects, HAIs create significant burdens for healthcare organizations in the form of associated financial and reputational costs. With several federal initiatives currently under consideration to improve HAI prevention, there's no time like the present for organizations to initiate or enhance their infection surveillance programs.

The cost of HAIs 
In terms of financial impact, HAIs cost hospitals nearly $10 billion annually in direct medical costs.² The average cost to treat the five most common HAIs is reported at:
 

• $45,814 for a central line-associated bloodstream infection.
    
• $40,144 for ventilator-associated pneumonia.
    
• $20,785 for a surgical site infection.
    
• $11,285 for a clostridium difficile infection.
    
• $896 for a catheter-associated urinary tract infection.³
    

Progress report
The good news is that HAI rates appear to be declining, with a 21 percent decrease reported for acute care hospitals between 2010 and 2015.⁴  The decline is due, in large part, to these various initiatives: 
 

• In 2008, the Centers for Medicare & Medicaid Services (CMS) issued new regulations denying payment for certain hospital-acquired conditions — including three common HAIs.
   
• CMS publicly reports the infection rates of individual hospitals through its Hospital Compare website.
   
• The Centers for Disease Control and Prevention (CDC) have established the National Healthcare Safety Network, in order to identify types of HAIs, facilitate accurate reporting, and permit tracking and comparison over time.
   
• In 2015, The Joint Commission implemented a National Patient Safety Goal for accredited hospitals seeking to reduce the prevalence of HAIs.
   
• As of August 2016, 34 states and Washington, D.C., require public reporting of HAI rates.
   

Preventive Measures
In addition to staff adherence to universal infection control precautions, these essential measures help healthcare organizations further reduce the dangers, reimbursement consequences and liabilities associated with HAIs:
 

1. Environmental Hygiene. Institute an aggressive environmental hygiene program throughout the facility to ensure these goals are met:
   • Educate staff members and physicians about risks associated with frequently contaminated objects and surfaces.
      
   • Limit use of non-critical equipment — such as blood pressure cuffs, stethoscopes and EKG wires — to single patients, or provide disposable options.
      
   • Ensure the purchase of waterproof materials that can easily be wiped clean.
      
   • Perform regular risk assessments utilizing the CDC HAI Prevention Toolkits and document corrective measures for noted deficiencies.
      
   • Train housekeeping personnel to thoroughly scrub walls, floors and surfaces at regular intervals with a high-level disinfectant.
      
   • Test surfaces for bacteria and other microbeson a scheduled basis.
      
    
2. Antibiotic Stewardship. Craft written protocols designed to ensure that antibiotics are prescribed only when medically indicated, in order to curb the proliferation of methicillin-resistant Staphylococcus aureus bacteremia and similar pathogens. In addition, the CDC recommends that all acute care hospitals implement an antibiotic stewardship program, containing seven core elements: 1) leadership commitment, 2) accountability, 3) drug expertise, 4) action, 5) tracking, 6) reporting and 7) education.
    
3. Injection Practices. Increase staff awareness of unsafe injection practices and their role in outbreaks of various diseases. For materials to aid in this effort, see the CDC One & Only Campaign and its multimedia toolkit, containing educational materials for patients and providers in various healthcare settings.
    

By focusing on environmental surveillance, antibiotic usage restraint and safe injection practices, organizations can significantly reduce HAIs and minimize both liability exposure and non-reimbursable costs.

¹ Centers for Disease Control and Prevention, HAI Data and Statistics. March 2, 2016
² Barnet, S. "25 Things for Healthcare CFOs to Know about HAIs," Becker's Hospital Review, Oct. 5, 2015.
³ Zimlichman, E., et al. "Health Care-associated Infections: A Meta-analysis of Costs and Financial Impact on the US Health Care System." JAMA Internal Medicine. December 9-23, 2013, Volume173:22, pages 2039-46.
⁴ According to a report issued by the Agency for Healthcare Research and Quality.