Infection Prevention and Control Advisory Committee

1

• Infection Prevention and Control Advisory
  Committee
• November 19, 2008
• Review of Arizona Activities in Infection
  Prevention and Control
• Patty Gray RN, BAHSA, CIC

2
Objectives

• To share background information about
• Arizona State, Federal Regulations, and
  Accreditations that govern infection prevention
  programs
• Existing hospital program requirements
• Improvement Initiatives Striving for an
  Irreducible Minimum
• Public Reporting Arizona Status

3
Regulatory, Accrediting, Public Agency
Oversight

• County State Public Health Agencies
• Arizona State Statutes
• Title IX, Licensing Certification (Survey)
• Chapter 6 Communicable Diseases (Reportable DZ)
• Federal Center for Medicare and Medicaid Services
  (CMS) COPs (Acute LTC) (Survey)
• Occupational Safety and Health Administration
  (OSHA)
• The Joint Commission (Survey)
• Centers for Disease Control and Prevention
  (CDC)/NHSN (Recommendations/Voluntary)
• IHI NQF AHRQ (Recommendations)

4
Hospital Infection Prevention Programs

• Infection Prevention and Control is a legislated,
  functional program that exists in hospitals
  throughout the US to prevent and control
  communicable diseases and Hospital - Associated
  Infections.
• 1950sFirst Efforts - Intensive Care Units
• 1960s -1970s SENIC study 32 Decrease in
  Infections
• 1980s -1990s state and federal agencies,
  professional organizations and scientific
  information.
• 2000s Evidenced-based strategies Consumer
  input NHSN

5
Comprehensive Infection Prevention Programs

• Program Goals protect Patients and Healthcare
  Workers from infection through
• Risk Assessment organizational and patient
  population needs-Targeted Indicators
• Surveillance (CDC)Data Analysis Reporting
• Outbreak Investigation
• Education
• Policy and Procedure development using
  evidenced-based, cost effective strategies
• Performance Improvement Initiatives

6
Infection Preventionists

• Association for Professionals in Infection
  Control and Epidemiology (APIC)
• National and International Organization 10,000
  members Created in 1972
• (Acute Care LTC - Assisted Living - Hospice
  Public Health - Dental-Behavioral-Vendors)
• Arizona APIC Chapter represents Hospitals
  throughout the state130 members
• Certification RNs/ MPHs/Med Techs No staffing
  ratios

7
Surveillance and Initiatives Targeted-Risk
Adjusted

• Communicable / Reportable Diseases (88 )
• Hand Hygiene compliance
• Central Line Associated Infections proper
  techniques and skin disinfectants
• Ventilator-Associated pneumonia ICU patients
• Surgical Site Infections Timeliness of pre-op
  antibiotics glycemia control thermia
• Antibiotic Resistant Bacteria / Stewardship

8
Public Reporting at National Level

• Leadership
• APIC, SHEA, AHA, Consumers Union
• National Quality Forum (NQF)
• CDC/NHSN
• Requires
• National Standardized Definitions and Risk
  Adjusted Indicators
• Sound Collection Databases
• Meaningful / Actionable Data

9
Current Public Reporting

• Hospital Compare www.HospitalCompare.gov
• CMS Core Measures (Pneumonia SCIP)
• CMS Never Events
• HealthGrades
• LEAPFROG
• Individual Hospital Websites
• Joint Commission
• Recent Kaiser Family Foundation Findings

10
National Healthcare Safety Network-CDC (NHSN)

• CDC Definitions for HAI determination
• Voluntary / Planned submission of indicator data
  by organization (491 ? 1722) 8/08
• National Benchmarking
• Secure Database option for State to view
• Resource Dependent and Technology Heavy

11
Arizona Infection Prevention Status

• Hospitals participating in
• Public Reporting venues (i.e. Hospital Compare
  CMS)
• AzHHA MRSA Initiative Hospital and Community
• Voluntary Patient Safety Initiatives (IHI)
• Community - Public Sector
• Public Health / ADHS Epidemiology Reportable
  Disease Education (i.e. MRSA / Influenza)
• Active Consumer Union dialogue with Legislators
• SB1356 formed Infection Prevention Advisory
  Committee Prevention Strategies

12
Next Steps

• Related to infection prevention
• What is REALLY needed to improve patient safety
  healthcare outcomes?
• ( Community Hospital )
• Where can our healthcare resources be best
  spent?