Interdisciplinary Approach to Reducing Healthcare Associated Infections Amid COVID-19 Pandemic

BACKGROUND: The COVID-19 pandemic has challenged acute-care hospitals (ACH) in numerous ways including increases in healthcare associated infections (HAI). The Centers for Disease Control and Prevention (CDC) 2020 Annual National and State HAI Progress Report denotes a 24% increase in central line associated bloodstream infections (CLABSI) between 2019 and 2020 with a 50% increase in the intensive care units (ICU) and minimal change in catheter associated urinary tract infections (CAUTI). METHODS: An interdisciplinary Healthcare Acquired Conditions (IHAC) team was implemented in a mid-size community hospital in Wisconsin to focus on the increase of HAI's during the pandemic. The IHAC team began meeting in November 2020 to discuss HAI events in real time and identify opportunities for improvement. The IHAC team was co-led by Nursing and Quality with standing membership including Infection Prevention, Risk, Safety, and Site Leadership. After HAI identification, IP communicates HAI event to the attribution unit. The unit reviews the medical record to complete a standardized tool and shares findings at the IHAC meeting. During the IHAC review, the team identifies improvement opportunities and assigns accountability with site leadership support. RESULTS: Since the IHAC team was established, there was an ongoing decline in HAIs. The following events were reported from January to December 2020: five (5) ICU CLABSI with a standardized infection ratio (SIR) 2.770 and two (2) non-ICU CLABSI SIR 0.667; two (2) ICU CAUTI SIR 1.002 and eight (8) non-ICU CAUTI SIR 1.864. After implementation of the IHAC team, there was a decrease in CAUTI and CLABSI events in January to September 2021: one (1) ICU CLABSI SIR 0.609 and one (1) non-ICU CLABSI SIR 0.318; one (1) ICU CAUTI SIR 0.573 and two (2) non-ICU CAUTI SIR 0.455. CONCLUSIONS: HAI reduction is achievable with an interdisciplinary approach discussing and identifying opportunities for improvement with the support of senior leadership.