Enhancement of Health Department Capacity for Health Care–Associated Infection Prevention Through Recovery Act–Funded Programs

Ellingson, Katherine; McCormick, Kelly; Sinkowitz‐Cochran, Ronda L.; Woodard, Tiffanee; Jernigan, John A.; Srinivasan, Arjun; Rask, Kimberly J.; Analysts,

doi:10.2105/ajph.2013.301809

Cited by 10 publications

(7 citation statements)

References 8 publications

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“…There is a growing evidence base establishing the efficacy of HAI prevention collaboratives that emphasise health system change through surveillance, data feedback, systematic implementation of prevention measures, and intrafacility and interfacility collaboration 19–21. Other researchers have surveyed DOH about their HAI prevention activities and found that between 2009 and 2011, just prior to our study period, federal funding had resulted in 60 prevention collaboratives 22. Therefore, it is not surprising that we found increased partnerships described by interviewees in all states.…”

Section: Discussionmentioning

confidence: 71%

Impact of laws aimed at healthcare-associated infection reduction: a qualitative study

et al. 2015

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Background Healthcare-associated infections (HAIs) are preventable. Globally, laws aimed at reducing HAIs have been implemented. In the USA, these laws are at the federal and state levels. It is not known whether the state interventions are more effective than the federal incentives alone. Objective The aims of this study were to explore the impact federal and state HAI laws have on state departments of health and hospital stakeholders in the USA and to explore similarities and differences in perceptions across states. Methods A qualitative study was conducted. In 2012, we conducted semistructured interviews with key stakeholders from states with and without state-level laws to gain multiple perspectives. Interviews were transcribed and open coding was conducted. Data were analysed using content analysis and collected until theoretical saturation was achieved. Results Ninety interviews were conducted with stakeholders from 12 states (6 states with laws and 6 states without laws). We found an increase in state-level collaboration. The publicly reported data helped hospitals benchmark and focus leaders on HAI prevention. There were concerns about the publicly reported data (eg, lack of validation and timeliness). Resource needs were also identified. No major differences were expressed by interviewees from states with and without laws. Conclusions While we could not tease out the impact of specific interventions, increased collaboration between departments of health and their partners is occurring. Harmonisation of HAI definitions and reporting between state and federal laws would minimise reporting burden. Continued monitoring of the progress of HAI prevention is needed.

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Section: Discussionmentioning

confidence: 71%

Impact of laws aimed at healthcare-associated infection reduction: a qualitative study

et al. 2015

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“…During the ELC Recovery Act cooperative agreement, NHSN enrollment increased across the country in large part due to Centers for Medicare and Medicaid Services incentives, whereas state mandates also motivated facilities to enroll in NHSN (Centers for Medicare and Medicaid Services, 2013). The state HAI programs were able to provide technical assistance to facilities for enrollment, getting started with reporting, and more than 55 validation projects (Ellingson et al, 2014). Despite gains made throughout the cooperative agreement relative to surveillance, all respondent types described the need for enhancements.…”

Section: Discussionmentioning

confidence: 99%

“…A conceptual program model was developed by CDC and guided the evaluation serving as the basis for expectations related to health department functioning and performance (Ellingson et al, 2014). The purpose of this model was to elucidate the pathway between the funding distributed to state health departments for HAI prevention and the desired outcome of safer health care.…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…A quantitative evaluation of the ELC Recovery Act HAI cooperative agreement showed that funding amount was significantly associated with HAI program capacity enhancements, specifically staffing, partnerships, training, technical assistance, surveillance, and prevention; this quantitative evaluation also showed that states funded for prevention collaborative implementation demonstrated greater infection reduction than states without funding for prevention collaboratives (Ellingson et al, 2014). To complement this quantitative component of the evaluation, a qualitative assessment was undertaken by CDC in collaboration with contracted evaluation experts from IMPAQ International and RAND Corporation (IMPAQ/RAND) to gain a more in-depth perspective from state-level stakeholders on the implementation of HAI programs.…”

Section: Introductionmentioning

confidence: 99%

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Perspectives on Federal Funding for State Health Care–Associated Infection Programs

et al. 2014

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In September 2009, federal funding for health care-associated infection (HAI) program development was dispersed through a cooperative agreement to 51 state and territorial health departments. From July to September 2011, 69 stakeholders from six states-including state health department employees, representatives from partner organizations, and health care facility employees-were interviewed to assess state HAI program achievements, implementation barriers, and strategies for sustainability. Respondents most frequently cited enhanced HAI surveillance as a program achievement and resource constraints as an implementation barrier. To sustain programs, respondents recommended ongoing support for HAI prevention activities, improved surveillance processes, and maintenance of partnerships. Findings suggest that state-level HAI program growth was achieved during the cooperative agreement but that maintenance of programs faces challenges.

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“…The principal obstacles to the development and maintenance of infection control and prevention programmes are the need of an adequate number of trained personnel in the team, and the motivation of employees to attend such courses [24–26]. Hence, it is important to understand the burden of disease and identify points for improvement in each clinical environment in order to establish an optimal programme.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a programme to reduce the burden of catheter-related bloodstream infections in a tertiary hospital

et al. 2016

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The objective of this study was to assess the effectiveness of a catheter-related bloodstream infection (CR BSI) reduction programme and healthcare workers' compliance with recommendations. A 3-year surveillance programme of CR BSIs in all hospital settings was implemented. As part of the programme, there was a direct observation of insertion and maintenance of central venous catheters (CVCs) to determine performance. A total of 38 education courses were held over the study period and feedback reports with the results of surveillance and recommendations were delivered to healthcare workers every 6 months. A total of 6722 short-term CVCs were inserted in 4982 patients for 58 763 catheter-days. Improvements of compliance with hand hygiene was verified at the insertion (87·1-100%, P < 0·001) and maintenance (51·1-72·1%, P = 0·029) of CVCs; and the use of chlorhexidine for skin disinfection was implemented at insertion (35·7-65·4%, P < 0·001) and maintenance (33·3-45·9%, P < 0·197) of CVCs. There were 266 CR BSI incidents recorded with an annual incidence density of 5·75/1000 catheter-days in the first year, 4·38 in the second year [rate ratio (RR) 0·76, 95% confidence interval (CI) 0·57-1·01] and 3·46 in the third year (RR 0·60, 95% CI 0·44-0·81). The education programme clearly improved compliance with recommendations for CVC handling, and was effective in reducing the burden of CR BSIs.

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Enhancement of Health Department Capacity for Health Care–Associated Infection Prevention Through Recovery Act–Funded Programs

Abstract: ARRA-HAI funding substantially improved HD capacity to reduce HAIs not targeted by other national efforts, suggesting that HDs can play a critical role in addressing emerging or neglected HAIs.

Cited by 10 publications

References 8 publications

Impact of laws aimed at healthcare-associated infection reduction: a qualitative study

Impact of laws aimed at healthcare-associated infection reduction: a qualitative study

Perspectives on Federal Funding for State Health Care–Associated Infection Programs

Effectiveness of a programme to reduce the burden of catheter-related bloodstream infections in a tertiary hospital

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