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Preventing Healthcare-Associated InfectionsHealthcare-associated infections (HAIs) are infections that are acquired while a patient is receiving medical, surgical, or rehabilitative services in a healthcare setting. These infections are “one of the top ten leading causes of death in the United States”.[1] Healthcare-associated infections include Catheter-Associated Urinary Tract Infections (CAUTI), Ventilator-Associated Pneumonia (VAP), Surgical Site Infections (SSIs), Central Line-Associated Blood Stream Infections (CLABSI), and Multidrug Resistant Organisms (MDROs), the most well known of which is Methicillin-Resistant Staphylococcus Aureus (MRSA).
Vermont’s healthcare community has a long history of working to reduce and eliminate HAIs in Vermont. Nationally, infection prevention and control came into being as a separate specialty in the 1960s and 1970s. Although the concept of infections related to healthcare dates back to the 19th century with the work of Nightingale, Pasteur, Lister and Semmelweis, structured prevention programs didn’t emerge until the second half of the 20th century. Hospital surveillance was born in the 1960s as a result of the Staphylococcus aureus pandemic that swept the country and was particularly devastating in newborn nurseries. Training courses in Infection Prevention and Control were first offered in the 1970s by the Centers for Disease Control and Prevention (CDC). A certification exam was established in the 1980s to allow nurses and medical technologists to demonstrate their proficiency in this complex field. In 1985, the Infection Control Professionals (now known as Infection Prevention Professionals) in Vermont formed an organization to network and share ideas. The Vermont Infection Control Practitioners Association (VICPA), meets at least twice a year and provides an opportunity for members to collaborate on best practices. Over the years, several educational programs developed for Infection Prevention Professionals in both acute and long-term care have been offered through this organization. This group of professionals is passionate about reaching that elusive goal of zero healthcare-associated infections in Vermont.
Establishing a Prevention Collaborative
John Jernigan, MD MS (CDC/CCID/NCPDCID) Deputy Chief of the Prevention and Response Branch at the Centers for Disease Control and Prevention described Vermont’s proposed Healthcare-Associated Infection Prevention Collaborative as “unique” and “innovative”; stating that he believed that “the healthcare facilities of Vermont, working in concert with public health authorities, have a real opportunity to lead the nation in addressing this difficult public health problem.”
The purpose is to establish a multicenter, evidence-based HAI Collaborative among acute care hospitals in Vermont. When looking at the scope of HAIs in the state, Multidrug Resistant Organisms (MDROs), specifically, MRSA and C-diff were identified as the focus of the Vermont HAI Collaborative. However, as the Infection Reporting and Prevention Work Group continued to meet, and through conversations with infection prevention professionals (IPPs) at hospitals across the state, it became evident that in order to really effect the rate of MDRO infections in the state, the Collaborative needed to focus not only on hospitals but on possible sources of transmission within the community. Long-term care was identified as an area of focus. It was decided that the Vermont HAI MDRO Prevention Collaborative would include both teams from the acute care hospitals and from long-term care facilities. At this point in the process the CDC expressed an interest in supporting our work with in-kind resources, using Vermont as a pilot site for reducing and eliminating the transmission of MDROs across the healthcare spectrum. With planning for this Collaborative well under way, the planning committee, made up of IPPs from the acute care setting, administrators from the long-term setting, staff from both the VDH and VPQ, as well as experts from the CDC, has begun meeting weekly to define the educational objectives of the HAI MDRO Collaborative.
John Jernigan MD MS (CDC/CCID/NCPDCID) Deputy Chief of the Prevention and Response Branch at the CDC is scheduled as the keynote speaker at the first Learning Session scheduled in September (Figure 5). Plans are also in place for two webinars to take place over the summer, and for teams to begin gathering baseline data with the help of the CDC. We look forward to an exciting year.
[1] http://www.cdc.gov/ncidod/dhqp/healthDis.html
[2] www.vthospitalreportcards.info
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