November 2019

    2019 National and State Healthcare-Associated Infections (HAI) Progress Report

    The 2019 HAI Progress Report highlights significant progress in reducing some HAIs, while identifying areas where more improvements are needed. Between 2018 and 2019, significant national reductions in acute care hospitals (ACH) were seen in central line-associated bloodstream infections (CLABSI, 7%), catheter-associated urinary tract infections (CAUTI, 8%), surgical site infections (SSIs) related to colon surgery (4%) and hospital-onset C. difficile infection (CDI, 18%), while no significant change was observed in hospital-onset methicillin-resistant Staphylococcus aureus (MRSA) bacteremia, and SSIs related to the 10 Surgical Care Improvement Project (SCIP) procedures. A significant increase in ventilator-associated events (VAE, 2%) was observed in ACHs in 2019 compared to 2018. In long-term acute care hospitals (LTACHs), significant reductions were seen in CLABSI (11%), CAUTI (9%), hospital-onset CDI (16%), and VAE (30%), while no significant changes were observed hospital-onset MRSA bacteremia.

    In inpatient rehabilitation facilities (IRFs), a significant reduction was seen in hospital-onset CDI (8%), CLABSI (13%), CAUTI (2%), and MRSA bacteremia (12%). The national progress in reducing HAIs shows that prevention is possible. Ongoing collaboration between public health, healthcare professionals, and other partners is critical to ensuring patient safety.

    Most healthcare facilities in the US were required to report select HAI data to NHSN in 2019 for participation in various CMS Quality Reporting Programs (QRPs), which results in census reporting. In 2018, CMS published changes in core measures reporting requirements for calendar year 2019 (https://www.registrypartners.com/cms-publishes-changes-in-core-measures-reporting-requirements-for-calendar-year-2019/), which impacted reporting for some HAIs in IRFs and LTACHs.

    On March 27th, an Extraordinary Circumstance Exception (ECE) Policy to the CMS Quality Reporting Programs was announced and applied to 2019Q4 data due to COVID-19 pandemic response activities. Many facilities across the nation were inundated with COVID-19 cases during the 2019Q4 CMS QRP reporting deadline. To alleviate some of the burden from facilities, CMS implemented an exception policy where facilities who were unable to report 2019Q4 HAI data to NHSN due to COVID-19 response activities were not penalized. Details of the exception are provided at the ECE link above. The impact of the ECE policy on the overall 2019 data is negligible as almost all facilities had reported their 2019Q4 data.

    Footnotes

    • The number of hospitals that reported to NHSN and are included in the SIR calculation. This number may vary across HAI types; for example, some hospitals do not use central lines or urinary catheters, or do not perform colon or abdominal hysterectomy surgeries.