A Partnership for the Future of Health Care

Health Care-associated Infection (HAI) Prevention Collaborative and Outreach Efforts

Health care-associated infections (HAIs) are acquired in a health care setting by patients that receive treatment for other conditions. HAIs are a leading cause of death in the United States and are a common complication of hospital care. Following evidence-based prevention guidelines can greatly reduce the numbers of HAIs. Under contract with the New Mexico Department of Health (NM DOH), NMMRA is working with providers in the state to help them reduce the incidence of cases of HAIs.

The New Mexico HAI Advisory Committee was created under the authority of House Joint Memorial 67 in 2007 and legislation enacted in 2009. Facilitated by NM DOH, the committee, which includes NMMRA participation, is currently working toward its goals related to public reporting and prevention of HAIs. Goals of the state HAI plan include surveillance, research, communication and metrics for measuring progress towards national goals. Three overarching priorities have been identified:

Meet or exceed the five-year national prevention targets for selected HAIs (e.g., 50 percent to 70 percent reduction in bloodstream infections)
Improve data systems and assess progress towards meeting the targets
Adoption of evidence-based prevention practice

As part of its HAI plan, NM DOH contracts with NMMRA to assist with educational and outreach efforts in the following areas.

Central Line-associated Bloodstream Infection (CLABSI) Prevention

The first prevention target chosen for improvement in the state in 2009 was reducing the rate of CLABSI. The CLABSI Prevention Collaborative of New Mexico began in 2010 to help participating hospitals develop surveillance standards and best practices, educate patients and providers, and, by working together, ultimately decrease the rate of CLABSIs. The CLABSI Collaborative is the first HAI prevention collaborative to be funded by the NM DOH through an American Recovery and Reinvestment Act (ARRA) grant received from the Department of Health and Human Services. A steering committee of clinical and program experts supports participating improvement teams through meetings, calls and educational activities. The goal of the collaborative is to decrease the rate of CLABSIs by at least 20 percent in the group of participating hospitals. To achieve this outcome, the collaborative members work to establish the use, documentation, and audit of the CLABSI checklist, with a goal of 80 percent achievement of the participating facilities by the end of the collaborative.

Health Care Personnel (HCP) Influenza Vaccinations

Increasing HCP influenza vaccination rates was chosen in 2009 as a second HAI prevention target based on significant opportunity for improvement. Using a theme that NMMRA tested and which was proven successful in the past, “It’s Worth a Shot,” NMMRA prepared a variety of educational materials to assist providers in increasing HCP vaccinations for the 2010-2011 flu season. NMMRA also supports providers through webinars and informational calls. New Mexico health care providers can obtain a CD of these tools and materials for improving HCP vaccinations by contacting Anne Timmins, BChD, MPH, NMMRA project manager, at atimmins@nmmra.org.

Clostridium Difficile (C. difficile) Infection Prevention

The prevention target chosen for improvement in 2011 is C. difficile. Clostridium difficile (C. difficile) is an anaerobic spore forming bacillus which causes an infection and can cause a range of disease from a mild diarrheal illness to colitis, sepsis and even death. Prerequisites for C. difficile infection are acquisition of C. difficile and antibiotic suppression of the normal colonic flora. C. difficile infection has been increasing in incidence over the last one to two decades, and the mortality rate from C. difficile increased in the population from 5.7 per million in 1999 to 23.7 per million in 2004. Excess costs attributable to C. difficile have been estimated at between $2,000 and $3,000 per hospitalization and up to $7,000 for inpatient costs. Since there are disproportionate increases in incidence and mortality in patients over 65 years old, and a recent estimate put the number of cases in nursing homes annually at over 263,000 cases, the prevention work will involve both hospitals and nursing homes. NMMRA will work with its partners on the health care associated infections advisory committee to focus on reducing the incidence of Clostridium difficile infections. Resources developed for infection prevention include: CDI Prevention Project Nursing training module.

For more about NM DOH’s HAI efforts, visit http://nmhealth.org/HAI/index.shtml.