Phase 3 of the 5-year National Action Plan to Prevent Healthcare-associated Infections: Roadmap to Elimination (HAI Action Plan) is now available for public comment. Phase 3 contains the new Long-Term Care (LTC) chapter pertaining to combatting healthcare-associated infections (HAIs) in nursing homes and skilled nursing facilities.
Earlier components of the HAI Action Plan focused on acute care hospitals (phase 1), ambulatory surgical centers and end-state renal disease facilities (Phase 2) and influenza vaccination of healthcare personnel (Phase 2).
The LTC chapter proposed in the HAI Action Plan will expand federal and nonfederal partner activities to address HAIs in LTC settings. This includes “urinary tract infection (UTI), lower respiratory tract infections, influenza and influenza-like illness, Clostridium difficile infection (CDI), and skin, soft tissue, and wound infections.”
1. Clostridium difficile infection (CDI) rates have reached epidemic levels among the general population. Hospitalization rates doubled from 2000 to 2005 and the death rate increased five-fold from 1999 to 2004. Hospitalization and death rates are disproportionately higher among persons aged 65 years and older. In at least one state, more than half of healthcare-associated CDI cases are estimated to manifest in nursing homes. The situation is complicated by increased rates of antibiotic resistance among older persons, which can make treatment more difficult.
2. Urinary tract infection (UTI), including catheter-associated UTI, or CAUTI, is the most commonly reported and treated infection in nursing homes and skilled nursing facilities. It is also a leading driver of 30-day hospital readmissions from those facilities. As with CDI, UTI treatment can be complicated by past antibiotic treatment. Unique diagnostic and management challenges for older patients also add complexity.
HHS is encouraging comments from the general public, state and local health agencies, professional groups, foundations, Medicare and Medicaid-related organizations, insurers, business groups, and others.
Comments should be directed to OHQ@hhs.gov. They will be accepted until 5:00 pm (ET) on August 22, 2012.
Click here to read the HHS Announcement.
The LTC Chapter can be found here.