Healthcare-associated infections (HAIs) are distinguished among the most common causes of preventable deaths in the United States of America. The U.S. Department of Health and Human Services (HHS) has included the problem in the national efforts within the Healthy People 2020 initiative. The control over central line-associated bloodstream infections (CLABSI) and methicillin-resistant Staphylococcus aureus (MRSA) are included in the objectives of the program. Significant progress has been achieved due to the implementation of the National Action Plan to Prevent Healthcare-Associated Infections (HAI Action Plan). Nevertheless, the outcomes do not meet the national 2013 goals and must be improved by a better unification and coverage of preventive and control options.
The problem with HAIs is related to the new challenges of the quality of treatment and the infection complications that originate from medical procedures and surgical operations. The issue affects the duration of hospital stays, financial management, morbidity and mortality of patients in the clinical settings. Bacterial, fungal, and viral infections are known to occur in acute care units, same-day surgical centers ambulatory services, and long-term clinical facilities (Office of Disease Prevention, 2015). The most common infection cases are associated with the utilization of medical devices, injections, transmission of communicable infections within the clinical setting, and improper antibiotics treatment. As a result, HAIs are manifested in the urinary tract, bloodstream, and as a result of surgery. Because of insufficient infection control, most of the incidences occur in the acute health care setting. Reducing the cases of central line-associated bloodstream infections (CLABSI) and curbing methicillin-resistant Staphylococcus aureus (MRSA) infections are among the highest priority objectives. These objectives are marked as HAI-1 and HAI-2 respectively.
The HAI-1 and HAI-2 objectives are meant to provide consistency with the national and state initiatives and programs. According to the HAI-1 objective, it is desired to decrease the standardized infection ratio (SIR) from 1.0 to 0.25 (Healthy People, 2015). The second objective establishes the baseline on the level of 27.08 infections per 100,000 population and the planned reduction to 6.56 infections (Healthy People, 2015). Based on the collected data by the Centers for Disease Control and Prevention (CDC), preventability and the targets of objectives are included in the National Action Plan to Prevent Healthcare-Associated Infections: Roadmap to Elimination (HAI Action Plan).
Preventive options are suggested to be the guiding lines of the strategies designated to reduce HAIs. On the national level, prevention measures are considered effective since they significantly reduce the chances of HAIs occurrence and contribute to the reduction of medical costs. In 2009, the CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC) have generated the Guidelines for the Prevention of Intravascular Catheter-Related Infections (O’Grady et al., 2011). They have been designated as a response to the emerging challenges that occur in the field of infection prevention and control. In particular, they provide recommendations for the education on the proper intravascular catheter use, hand hygiene, aseptic procedures, antibiotic prophylaxis, and performance improvement among health care professionals (O’Grady et al., 2011). Preventability became the core concept of the HAI Action Plan implementation.
The HAI Action Plan is designated as a national preventing strategy for safe public health care in various clinical settings. The plan unites the efforts of health care leaders, scientists, and clinicians. The stakeholders from the main national health care organizations were involved in the discussion and partnership related to the project. The plan consists of three phases that deal with acute care hospitals, ambulatory surgical centers, end-stage renal disease facilities, and long-term care facilities (Office of Disease Prevention, 2015). The phases contribute to the establishment of innovative information systems and safe medical devices as well as the comprehensive control of the quality of care within diverse heath care settings. By means of the Preventive Health and Health Services Block Grant, the US government generates funds to satisfy the state public health care needs related to HAIs (Office of Disease Prevention, 2015). In addition to the plan, another initiative by HHS deals with the Partnership for Patients, which is meant to make the clinical settings safer in terms of the collaboration with patients. The HAI Action Plan has focused on the significant reduction of the cases of CLABSI and MRSA infections in the 5-year period.
The results of the HAI Action Plan show measurable progress in the reduction of the abovementioned infections. In particular, the SIR of CLABSI infections decreased to 0.54, and the rate of MRSA infections decreased to 18.28 per 100,000 population between 2008 and 2013 (CDC, 2015). Nevertheless, the numbers do not coincide with the desired national prevention target of the 50% reduction (Office of Disease Prevention, 2015). The most apparent progress refers to the incidences of MRSA infections. Meanwhile, only an 8% decrease is detected in the MRSA bacteremia cases between 2011 and 2013. The CDC plan to undertake more actions on all the health care levels that are related to control options and unification of actions between all the members of the healthcare facilities.
Healthcare-associated infections constitute one of the most apparent threats to the public health safety and reflect the quality of care in the clinical settings. Finding effective solutions for this issue is among the main goals of the Healthy People 2020 initiative. The principal objective is to reduce the cases of CLABSI and MRSA infections. Preventive measures undertaken in the course of the HAI Action Plan’s realization resulted in the significant reduction of the incidences, especially in the case of CLABSI. Nevertheless, the unreached 2013 targets point to the need for a broader scope of preventive and control options to be undertaken on all the levels of the health care system.