SHEA estimates preventable HAIs
Message is undeniable
In the absence of any meaningful literature that identify the number of preventable hospital-associated infections (HAIs) that occur in the Untied States, the Society for Healthcare Epidemiology of America (SHEA) was asked by Congress's Committee on Oversight and Government Reform to provide such an estimate. In a just released report, SHEA concludes that there are as many as 23,000-64,000 preventable deaths from HAIs every year.
The results were further broken down as follows:
- Bloodstream infections: 18%-82% of infections may be preventable, translating into 5,520-25,145 preventable deaths each year;
- Ventilator-associated pneumonia: 38%-71% of infections may be preventable, translating into 13,667-25,537 preventable deaths each year;
- Urinary tract infections: 17%-69% of infections may be preventable, translating into 2,225-9,031 preventable deaths each year;
- Surgical site infections: 28%-54% of infections may be preventable, translating into 2,133-4,431 preventable deaths each year.
"We were asked to try to come up with an estimate of the deaths associated with HAIs that are preventable," notes Patrick J. Brennan, MD, president of SHEA, and one of the study's authors. "There is no study that directly answers this in a meaningful way so we pulled from studies related to interventions in the four major HAIs."
The best information available, he notes, involved a study by the Agency for Healthcare Research and Quality (AHRQ), published in 2007, related to the prevention of HAIs, and a 2002 paper by the Centers for Disease Control and Prevention (CDC) that estimated the annual incidence of mortality from HAIs.
The researchers at the Center for Evidence-based Practice (CEP) at the University of Pennsylvania Health System, with which SHEA collaborated, noted that the CDC's data suggest there were 1.74 million HAIs and 99,000 estimated deaths. Two-thirds of these deaths were related to bloodstream infections and ventilator-associated pneumonia.
Next, they used the AHRQ report to estimate the fraction of HAIs that could be prevented. Third, the national survey and AHRQ data were combined to calculate the number of preventable HAIs and deaths each year.
"We took the HAI reductions observed in various studies and from there arrived at an estimate range," says Brennan.
Limitations noted
In the paper, Brennan and his co-authors note the limitations of their research. "It's important to take a look at the limitations of this method," he emphasizes. "There is considerable uncertainty because the components stem from estimates in low-quality studies."
Nevertheless, he continues, "I think it's fair to say there is a significant burden of death and disease related to HAIs that can be prevented. The exact magnitude is difficult to estimate, but we tried to do that."
There does exist a good deal of evidence for ways to reduce HAIs, he continues. "We know, for example, that that timing of antibiotic administration could be improved upon, and that is an evidence-based practice to prevent surgical site infection," Brennan shares. "We also know that a number of processes, when bundled together, can reduce bloodstream infections and ventilator- associated pneumonia. In addition, a key for preventing urinary tract infections is removal of the catheter — which is sometimes easier said than done, however."
Nonetheless, he concludes, "to the extent that major risk factors can be eliminated, the incidence of HAIs ought to be reducible "
[For additional information, contact:
Patrick J. Brennan, MD, President, Society for Healthcare Epidemiology of America, 1300 Wilson Boulevard, Suite 300, Arlington, VA 22209. Phone: (703) 684-1006. Fax: (703) 684-1009. E-mail: [email protected].]
In the absence of any meaningful literature that identify the number of preventable hospital-associated infections (HAIs) that occur in the Untied States, the Society for Healthcare Epidemiology of America (SHEA) was asked by Congress's Committee on Oversight and Government Reform to provide such an estimate.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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