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Guidance on Public Reporting of Healthcare-Associated Infections: Recommendations of the Healthcare Infection Control Practices Advisory Committee

Guidance on Public Reporting of Healthcare-Associated Infections: Recommendations of the HICPAC [PDF 150 KB]

Table 1. Recommended process measures for a mandatory public reporting system on health care–associated infections

Events Measures Rationale for inclusion Potential limitations
Central line insertion (CLI) practices Two measures (expressed as a percentage)6: Unambiguous target goal (100%) Methods for data collection not yet standardized
 

Numerators: Number of CLIs in
which:

  • Maximal sterile barrier precautions were used
  • Chlorhexidine gluconate (preferred),
    tincture of iodine, an iodophor, or 70% alcohol was used as skin antiseptic
 Risk-adjustment is unnecessary Manual data collection likely to be tedious and labor intensive, and data are not included in medical records
  Denominator: Number of CLIs

Proven prevention effectiveness 6:

  • Use of maximal barrier precautions during insertion and chlorhexidine skin antisepsis have been shown to be associated with an 84% and 49% reduction in central line–associated bloodstream infection rates, respectively.7,8
  
Surgical antimicrobial prophylaxis (AMP) Three measures (expressed as a percentage) 9: Unambiguous target goal (100%) Manual data collection may be tedious and labor intensive, but data can be abstracted from medical records
 

Numerators: Number of surgical patients:

  • Who received AMP within 1 hour prior to surgical incision (or 2 hours if receiving vancomycin or a fluoroquinolone)
  • Who received AMP recommended for their surgical procedure
  • Whose prophylactic antibiotics were discontinued within 24 hours after surgery end time
 Risk-adjustment is unnecessary  
  Denominator: All selected surgical patients

Proven prevention effectiveness 10:

  • Administering the appropriate antimicrobial agent within 1 hour before the incision has been shown to reduce SSIs
  • Prolonged duration of surgical prophylaxis (.24 hrs) has been associated with increased risk of antimicrobial-resistant SSI
  
Influenza vaccination of patients and health care personnel Two measures (each expressed as a percentage of coverage)11:
Numerators: Number of influenza
vaccinations given to eligible patients or healthcare personnel
Denominators: Number of patients or healthcare personnel eligible for influenza vaccine

Proven prevention effectiveness 11-13:

  • Vaccination of high-risk patients and health care personnel has been shown to be effective in preventing influenza
 Manual data collection may be tedious and labor intensive
 
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