• Mohamad G Fakih, Michelle Heavens, Carol J Ratcliffe, and Ann Hendrich.
• Department of Infection Prevention and Control, St. John Hospital and Medical Center, Detroit, MI; Wayne State University School of Medicine, Detroit, MI. Electronic address: Mohamad.Fakih@stjohn.org.
• Am J Infect Control. 2013 Nov 1;41(11):950-4.

BackgroundHospitals can better focus their efforts to prevent health care-associated infections (HAIs) if they identify specific areas for improvement.MethodsWe administered a 96-question survey to infection preventionists at 71 Ascension Health hospitals to evaluate opportunities for the prevention of catheter-associated urinary tract infection, central line-associated bloodstream infection, ventilator-associated pneumonia, and surgical site infection.ResultsSeventy-one (100%) infection preventionists completed the survey. The majority of hospitals had established policies for urinary catheter placement and maintenance (55/70, 78.6%), central venous catheter maintenance (68/71, 95.8%), and care for the mechanically ventilated patient (62/66, 93.9%). However, there was variation in health care worker practice and evaluation of competencies and outcomes. When addressing device need, 55 of 71 (77.5%) hospitals used a nurse-driven evaluation of urinary catheter need, 26 of 71 (36.6%) had a team evaluation for central venous catheters on transfer out of intensive care, and 53 of 57 (93%) assessed daily ventilator support for continued need. Only 19 of 71 (26.8%) hospitals had annual nursing competencies for urinary catheter placement and maintenance, 29 of 71 (40.8%) for nursing venous catheter maintenance, and 38 of 66 (57.6%) for appropriate health care worker surgical scrubbing.ConclusionWe suggest evaluating infection prevention policies and practices as a first step to improvement efforts. The next steps include implementing spread of evidence-based practices, with focus on competencies and feedback on performance.Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

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