title: A national collaborative for reducing health care‒associated infections: current initiatives, challenges, and opportunities.
abstract: There has been increasing interest and an upsurge in efforts to prevent hospital-associated infections (HAIs), a leading cause of death in the United States. This study was conducted to assess current strategies and efforts of HAI reduction initiatives in hospitals. HAI reduction initiatives and factors influencing institutional participation in these initiatives were categorized. Data were collected via open-ended questions on surveys performed in 5 different HAI collaboratives. Thematic analysis of the coded qualitative data was conducted. A total of 1,212 health care professionals from 33 different hospitals participated. Improving hand hygiene was the most frequently mentioned HAI reduction initiative implemented in the previous year. Initiatives for reducing central line or central venous catheter infections and ventilator-associated pneumonia also were commonly cited. The most frequently mentioned challenges to implementing HAI reduction initiatives included poor adherence, insufficient resources, staffing problems, lack of culture change, no impetus to change, and issues related to staff and patient education. Many respondents identified engaging physicians as particularly challenging.These findings suggest that consistently improving hand hygiene remains a widespread problem for reducing HAIs and sustaining this type of behavioral change is difficult. Furthermore, ensuring staff and physician engagement and compliance in HAI reduction efforts remains challenging for most hospitals.
authors.affiliation: Indiana University (IU) Center for Health Services & Outcomes Research, Indianapolis, IN. Electronic address: meflanag@iupui.edu.
authors.forename: Mindy E
authors.initials: ME
authors.lastname: Flanagan
authors.affiliation: Regenstrief Institute, Inc., Indianapolis, IN.
authors.forename: Catherine Amber
authors.initials: CA
authors.lastname: Welsh
authors.affiliation: Department of Veterans Affairs Health Services Research and Development Center of Excellence, Indianapolis, IN.
authors.forename: Chris
authors.initials: C
authors.lastname: Kiess
authors.affiliation: Department of Veterans Affairs Health Services Research and Development Center of Excellence, Indianapolis, IN.
authors.forename: Shawn
authors.initials: S
authors.lastname: Hoke
authors.affiliation: Indiana University (IU) Center for Health Services & Outcomes Research, Indianapolis, IN; Regenstrief Institute, Inc., Indianapolis, IN; Department of Veterans Affairs Health Services Research and Development Center of Excellence, Indianapolis, IN; VA HSR&D Center on Implementing Evidence-Based Practice, Roudebush VAMC, Indianapolis, IN; Department of Medicine, School of Medicine, Indiana University, Indianapolis, IN.
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Doebbeling
mesh_terms: D003299:Cooperative Behavior; D003428:Cross Infection / Q000517:prevention & control*; D019983:Guideline Adherence; D006235:Hand Disinfection / Q000379:methods; D019538:Health Care Surveys; D006282:Health Personnel; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000592:standards*; D011785:Quality Assurance, Health Care; D014481:United States