title: Enhancement of health department capacity for health care-associated infection prevention through Recovery Act-funded programs.
abstract: OBJECTIVE
  We evaluated capacity built and outcomes achieved from September 1, 2009, to December 31, 2011, by 51 health departments (HDs) funded through the American Recovery and Reinvestment Act (ARRA) for health care-associated infection (HAI) program development.
  
  
  METHODS
  We defined capacity for HAI prevention at HDs by 25 indicators of activity in 6 categories: staffing, partnerships, training, technical assistance, surveillance, and prevention. We assessed state-level infection outcomes by modeling quarterly standardized infection ratios (SIRs) for device- and procedure-associated infections with longitudinal regression models.
  
  
  RESULTS
  With ARRA funds, HDs created 188 HAI-related positions and supported 1042 training programs, 53 surveillance data validation projects, and 60 prevention collaboratives. All states demonstrated significant declines in central line-associated bloodstream and surgical site infections. States that implemented ARRA-funded catheter-associated urinary tract infection prevention collaboratives showed significantly greater SIR reductions over time than states that did not (P = .02).
  
  
  CONCLUSIONS
  ARRA-HAI funding substantially improved HD capacity to reduce HAIs not targeted by other national efforts, suggesting that HDs can play a critical role in addressing emerging or neglected HAIs.
authors: Katherine Ellingson, Kelly McCormick, Ronda Sinkowitz-Cochran, Tiffanee Woodard, John Jernigan, and Arjun Srinivasan are with the Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta GA. Kimberly Rask is with the Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta.
authors: Katherine
authors: K
authors: Ellingson
authors: Kelly
authors: K
authors: McCormick
authors: Ronda
authors: R
authors: Sinkowitz-Cochran
authors: Tiffanee
authors: T
authors: Woodard
authors: John
authors: J
authors: Jernigan
authors: Arjun
authors: A
authors: Srinivasan
authors: Kimberly
authors: K
authors: Rask
mesh_terms: D057171:American Recovery and Reinvestment Act / Q000191:economics / Q000458:organization & administration*; D057191:Capacity Building / Q000191:economics / Q000458:organization & administration; D003428:Cross Infection / Q000191:economics / Q000517:prevention & control*; D006077:Government Agencies / Q000191:economics / Q000458:organization & administration; D006801:Humans; D016730:Program Development; D011634:Public Health / Q000191:economics; D013219:State Government; D014481:United States