Oregon is one of ten states in the country with a mandatory statewide public reporting program for healthcare acquired infections. All hospitals are required to report three of the most common infections: central lineassociated bloodstream infections, those that occur after knee replacement surgery, and those connected with coronary bypass grafts.

In 2009, there were 199 reported infections from 50 hospitals. The infection rate breaks down as follows:

• The Oregon infection rate for central line-associated bloodstream infections is 1.2 infections per 1,000 central line days, approximately 38 percent lower than the national average of 1.92. (A central line is a catheter inserted directly into a large vein that enables rapid administration of fluids, blood or medications.)
• The Oregon coronary bypass graft infection rate is 2.01 percent, approximately 30 percent lower than the national rate of 2.86 percent.
• The Oregon knee replacement infection rate is 0.82 percent, which is similar to the national rate of 0.89 percent.

"Healthcare acquired infections can be serious and costly. They are also largely preventable," says Tina Edlund, deputy director of the Oregon Health Authority. "This information gives us a place to start as we improve patient safety. We are working closely with our partners in the healthcare community and patient advocates to do as much as possible to eliminate these infections."

Healthcare acquired infections are among the top 10 leading causes of death in the United States and cost some $33 billion per year nationally. In Oregon, the cost per stay for patients that experience healthcare acquired infections increases an average of $32,000.

Preventing these infections has become a key element to improve patient care and lower costs in the healthcare system. Hospital infections are a national problem. In 2011, federal health reform will begin requiring national reporting of infections and Medicare will stop reimbursing providers for costs associated with treating them.

"Addressing the issue takes effort on two fronts, improving patient care and improving patient education," says Edlund.

Healthcare providers are increasing improvement and awareness of the issue. Several Oregon hospitals are participating in projects that address training and practices for hand hygiene, peer accountability and improved practices. The Oregon Association of Hospitals and Health Systems (OAHHS) coordinates several patient-safety clinical projects to specifically address hospital infections with its hospital members. Oregon hospitals are committed to eliminating all healthcare acquired infections. More information can be found online at www.oahhs.org/quality

"Oregon's hospitals are committed to working in a transparent way to eliminate all healthcare acquired infections in our state. Patient safety is our number-one responsibility," commented Dr. Steve Gordon, member of the OAHHS Quality Committee and chief quality officer for PeaceHealth Oregon. "This first report illustrates that, although Oregon is ahead of national averages in terms of reducing healthcare acquired infections, there is still much more work to be done. Addressing HAI is a top priority of every hospital in this state."

Additionally, patients can reduce the risk of infection by taking all the pre-hospitalization infection prevention steps their doctors recommend, such as pre-surgical chlorhexidine baths, not shaving before surgery and stopping smoking. They should also take antibiotics and other medications exactly as directed by their doctors, and ask their visitors to stay home if they are sick.

The first Oregon Healthcare Acquired Infections Report stems from legislation passed in 2007 to create a mandatory reporting program to raise awareness, promote transparency for healthcare consumers and motivate healthcare providers to prioritize prevention. The Oregon Health Authority's Healthcare Acquired Infections Committee is working to expand the program in hospitals and is collecting information in other surgical facilities beyond hospitals.

The report, completed by the Oregon Health Authority's Office of Health Policy Research, is available at www.oregon.gov/OHPPR/Healthcare_Acquired_infections.shtml . To learn more about health reform work underway in Oregon, go to www.Oregon.gov/OHA.

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