Healthcare-Associated Infections

PSR NATIONAL SUMMARY

Icon depicting two hands washing with soapThe Prevention Status Reports highlight—for all 50 states and the District of Columbia—the status of public health policies and practices designed to address 10 important public health problems and concerns. This report highlights two practices to reduce healthcare-associated infections (HAIs) and antibiotic resistance (AR):

  • Implementing state activities to build capacity for HAI prevention
  • Implementing stewardship programs to improve antibiotic use in acute care hospitals

Improving health care through HAI and AR prevention, detection, and response are priorities for CDC, the US Department of Health and Human Services (HHS), and the White House. The White House’s National Strategy for Combating Antibiotic-Resistant Bacteria (CARB) and National Action Plan stress the judicious use of antibiotics to prevent transmission of AR infections (1,2). The HHS HAI action plan sets national goals for reducing HAIs and provides a framework for state HAI prevention plans (3). In CDC’s 2014 National Healthcare Safety Network (NHSN) Annual Hospital Survey, 39.2% of US hospitals reported having antibiotic stewardship programs (4) that included seven core elements CDC deems critical for such programs (5). 

Other strategies supported by evidence include optimizing infection control practices within healthcare facilities, using a coordinated regional approach to preventing infections, and implementing CDC’s Targeted Assessment for Prevention (TAP) strategy (6,7).

State activities to build capacity for HAI prevention

State health department implementation of activities to improve the state’s ability to prevent and control HAIs across four prevention areas: 1) building and maintaining partnerships (e.g., collaborating with quality improvement organizations or hospital associations), 2) supporting HAI-related outbreak response by building infrastructure to identify and respond to reports of outbreaks in healthcare settings, 3) conducting or supporting HAI training, and 4) validating HAI data (i.e., analyzing data for quality and completeness and/or reviewing medical records to check data accuracy).

RatingNumber of HAI prevention areas addressed
GreenAll four
YellowThree
RedTwo or fewer


How These Ratings Were Determined
These ratings reflect the number of HAI prevention areas each state has addressed. Ratings are based on data from a CDC 2015 survey of state HAI coordinators, which asked states whether their HAI prevention activities had addressed the following prevention areas: HAI partnerships, outbreak response, training, and data validation (8). Data validation responses were confirmed using the findings of the 2016 National and State Healthcare-Associated Infections Progress Report (9).

Stewardship programs to improve antibiotic use in acute care hospitals

Programs in acute care hospitals that incorporate seven core elements CDC deems critical to successful hospital antibiotic stewardship: 1) leadership commitment, 2) accountability, 3) drug expertise, 4) actions to improve antibiotic use, 5) tracking antibiotic use and outcomes, 6) reporting antibiotic use and outcomes to staff, and 7) education (5).

RatingPercentage of acute care hospitals with antibiotic stewardship programs
Green ≥75.0%
Yellow50.0%–74.9%
Red≤49.9%


How These Ratings Were Determined
These ratings reflect the percentage of each state’s acute care hospitals participating in the Patient Safety Component of NHSN that reported having antibiotic stewardship programs that incorporated CDC’s seven core elements (5). Ratings are based on data from the 2014 NHSN Annual Hospital Survey Patient Safety Component (4).

References

  1. The White House. National Strategy for Combating Antibiotic-Resistant BacteriaExternal Link. Washington, DC: The White House; 2014.
  2. The White House. National Action Plan for Combating Antibiotic-Resistant BacteriaExternal Link. Washington, DC: The White House; 2015.
  3. US Department of Health and Human Services. National Action Plan to Prevent Health Care-Associated Infections: Roadmap to EliminationExternal Link. Washington, DC: US Department of Health and Human Services. Updated Jun 2015.
  4. CDC. 2014 NHSN Annual Hospital Survey. Unpublished data, 2015.
  5. CDC. Vital signs: improving antibiotic use among hospitalized patients. MMWR 2014;63(9):194–200. CDC.
  6. CDC. Vital signs: estimated effects of a coordinated approach for action to reduce antibiotic-resistant infections in health care facilities—United States. MMWR 2015;64(30):826–31.
  7. CDC. The Five "W"s of the Targeted Assessment for Prevention (TAP) Strategy. Updated Jul 2015.
  8. CDC. 2015 State HAI Prevention Activities Survey. Unpublished data, 2015.
  9. CDC. National and State Healthcare-Associated Infections Progress Report. Atlanta, GA: US Department of Health and Human Services; 2016.


**State count includes District of Columbia.

Page last reviewed: 4/10/2019