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New era of transparency on health infection data
Central line infections drop 18%
In contrast to another recent federal report that cited little progress against health care associated infections (HAIs), the Centers for Disease Control and Prevention (CDC) reports an 18% decline in the national incidence of central line-associated bloodstream infections.
The report compares national and state data from January to June 2009 with national data from 2006 to 2008. The CDC's First State-Specific Healthcare-Associated Infections Summary Data Report is available at www.cdc.gov/hai/statesummary.html.
Gleaning data from the CDC's National Healthcare Safety Network (NHSN), the report includes national numbers as well as state-specific information from 17 states, said Arjun Srinivasan, MD, director of HAI Prevention in the CDC's division of healthcare quality promotion.
"This report gives us a snapshot of where the country stands in our efforts to prevent central line-associated bloodstream infections," he said at a CDC press conference. "Data from this report give us two key pieces of information. It tells us for the first time how we are performing nationally against central line-associated bloodstream infection prevention goals outlined in the U.S. Health and Human Services action plan to prevent healthcare-associated infection, and it will serve as the baseline from which states can assess their own progress toward eliminating these infections."
Indeed, the report is apparently only the first step in a sweeping new move toward transparency on HAI data. "The real test will be comparing the data [with] the data in future reports, which will be published every six months," Srinivasan said. "At that point we can judge progress over time and determine whether or not central line-associated bloodstream infection prevention efforts are driving infections down."
Secretary of Health Kathleen Sebelius said in a statement that "we will continue to expand access to health care data for policymakers, providers, and consumers so they can all make the most-informed health decisions possible. This administration is firmly committed to promoting transparency in our health care system so that we can know what's working, what's not, and how we can do better."
The Agency for Healthcare Research and Quality' recently issued a National Healthcare Quality Report (NHQR) that found that HAIs "are one of the most serious patient safety concerns. It is unfortunate that HAI rates are not declining. Of all the measures in the NHQR measure set, the one worsening at the fastest rate is postoperative sepsis. The two process measures related to HAIs tracked in the NHQR, both covering timely receipt of prophylactic antibiotics for surgery, are improving steadily. However, HAI outcome measures are lagging."
Leaders of infectious disease groups challenged the AHRQ conclusions and said the report was based on inaccurate and misleading data. On the other hand, the CDC report "shows significant progress in preventing HAIs in many of our nation's hospitals," the Association for Professionals in Infection Control and Epidemiology (APIC) said in a statement. "Collected in a standardized fashion, using standardized definitions, these data provide a solid benchmark against which future efforts can be measured and represent the quality of data that are needed for the prevention HAIs. APIC believes the NHSN surveillance network is the best currently available method for ensuring the establishment of a scientifically meaningful reporting and monitoring system for HAIs." (Editor's note: The AHRQ report can be found at www.ahrq.gov/qual/qrdr09.htm.)