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Health Topics - Healthcare-associated Infections (HAI)

1 in 25 patients is diagnosed with at least one infection related to hospital care.

OVERVIEW

HAIs are infections resulting from complications of healthcare. They are linked with high morbidity and mortality. Each year, about 1 in 25 patients is diagnosed with at least one infection related to hospital care alone. Additional infections occur in other healthcare settings1. Many HAIs are caused by the most serious antibiotic-resistant bacteria and can lead to sepsis or death.

ECONOMIC BURDEN

HAIs in U.S. hospitals have direct medical costs of at least $28.4 billion each year.2 They also account for an additional $12.4 billion in costs to society from early deaths and lost productivity.3

Risk Factors

Certain factors raise the risk of contracting HAIs:4

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Invasive procedures

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Severity of illness

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Not adhering to best practices for prevention

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Overuse or improper use of antibiotics

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Public Reporting and Validation5,6

Transparency and accountability are critical to the prevention of HAIs. Mandatory reporting to the state health department with public disclosure of data ensures reliable data for HAI tracking and increases accountability. As of January 2017, 35 states and the District of Columbia (DC) have passed laws pertaining to HAI prevention and reporting. Many states also have HAI-related regulations, indicative of the growing role of states in addressing this issue. A series of high-profile outbreaks following breaches in infection control procedures (particularly in outpatient settings) has led to regulatory and other policy actions in states. The same information is used by the Centers for Medicare and Medicaid Services (CMS).

Also see: https://www.cdc.gov/hai/pdfs/toolkits/toolkit-hai-policy-final_03-2011.pdf

Accreditation, Licensure, and Training7

Some states have implemented online training and accreditation for facilities and certification for practitioners.

Incentives7

States have employed innovative incentives to encourage providers to make the investments necessary to sustain prevention efforts. These incentives have included instituting subsidies to offset costs for updating electronic data systems and increasing the reimbursement rates for meeting HAI reduction targets.

Oversight7

States can adopt policies establishing regulatory oversight authority for the state health agency or commissioner of health.

State-based HAI Prevention: State Policy Resources8

Many of the most impactful and sustained examples of public health success have been driven and supported by effective public policies. Recent experiences with emerging and highly infectious diseases further highlight the need for clarity and consistency in public health and health policy. CDC has been working with health departments and other partners to identify policy options and best practices to support HAI prevention and improve healthcare outcomes. CDC’s state policy resources provide policy options for sepsis prevention and early recognition, improving outpatient settings, and other policy toolkits.


Featured Resources

CDC HAI Page

Overview of information on CDC’s research on HAIs.


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HAI Prevention Stories from the States

Success stories on topics including improving inpatient antibiotic prescribing, preventing central line-associated bloodstream infection (CLABSI), and preventing clostridium difficile infections.


Antibiotic Stewardship Programs (ASP) Core Element Documents

These resources summarize core elements of successful hospital ASP. They complement existing guidelines on ASPs from organizations including the Infectious Diseases Society of America in conjunction with the Society for Healthcare Epidemiology of America, American Society of Health System Pharmacists, and The Joint Commission.


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Antibiotic Resistance (AR) Investment Map

CDC’s strategic investments empower the nation to combat AR, the global threat jeopardizing modern medicine. The Fiscal Year 2017 investments shown on the investment map support comprehensive, coordinated, and ambitious public health action to meet national goals to prevent drug-resistant infections.



Featured Tools

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Targeted Assessment for Prevention (TAP) Strategy

Review the TAP Strategy framework for quality improvement. Developed by CDC to use data for action to prevent HAIs, the TAP Strategy consists of three components:

  1. Running TAP Reports in the National Healthcare Safety Network to target healthcare facilities and specific units with an excess burden of HAIs
  2. Administering TAP Facility Assessment Tools to identify gaps in infection prevention in the targeted locations
  3. Accessing prevention resources within the TAP Implementation guide to address those gaps

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Interim Guidance for a Health Response to Contain Novel or Targeted Multidrug-resistant Organisms (MDROs)

CDC developed this guidance for state and local health departments and healthcare facilities as a resource during the initial response for the containment of novel or targeted multidrug-resistant organisms (MDROs) or resistance mechanisms. The site also includes example scripts for requesting patient assent for MDRO screening and answers to patients’ frequently asked questions.


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CDC Toolkits

Presents prevention strategies for a variety of settings as well as different pathogens.


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Basic Infection Control and Prevention Plan for Outpatient Oncology Settings

Review a model for a basic infection control and prevention plan. It contains policies and procedure tailored to these settings to meet minimal expectations of patient protections as described in the CDC Guide to Infection Prevention in Outpatient Settings.


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Infection Control Assessment Tools

Access information to assist health departments in assessing infection prevention practices and guide quality improvement activities (e.g., by addressing identified gaps). These tools may also be used by healthcare facilities to conduct internal quality improvement audits.


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Antibiotic Resistance Patient Safety Atlas

View and filter data about HAIs caused by antibiotic resistant bacteria.


CDC Sortable Stats

Sortable Stats is an interactive data set comprised of behavioral risk factors and health indicators. This site compiles data from various published CDC and federal sources into a format that allows users to view, sort, and analyze data at state/territory, regional, and national levels.


  1. Magill, Shelley, et. al. Multistate Point-Prevalence Survey of Health Care–Associated Infections. N Engl J Med 2014; 370:1198-1208; March 27, 2014
  2. https://www.cdc.gov/hai/pdfs/hai/scott_costpaper.pdf
  3. Roberts RR, Scott RD II, Hota B, Kampe LM, Abbasi F, Schabowski S, Ahmad I, Ciavarella GG, Cordell R, Solomon SL, Hagtvedt R, Weinstein RA. Costs attributable to healthcare-acquired infection in hospitalized adults and a comparison of economic methods.
  4. https://archive.ahrq.gov/professionals/clinicians-providers/resources/nursing/resources/nurseshdbk/CollinsA_PHCAI.pdf
  5. https://www.cdc.gov/hai/pdfs/toolkits/ASTHO_One_Pager.pdf
  6. https://www.cdc.gov/hai/pdfs/toolkits/toolkit-hai-policy-final_03-2011.pdf
  7. https://www.cdc.gov/hai/pdfs/toolkits/ASTHO_One_Pager.pdf
  8. https://www.cdc.gov/hai/state-resources/policy.html
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