title: State focus on health care-associated infection prevention in nursing homes.
abstract: BACKGROUND
  Despite increased focus on health care-associated infections (HAI), between 1.6 and 3.8 million HAI occur annually among the vulnerable population residing in US nursing homes (NH). This study characterized state department of health (DOH) activities and policies intended to improve quality and reduce HAI in NH.
  
  
  METHODS
  We created a 17-item standardized data collection tool informed by 20 state DOH Web sites, reviewed by experts in the field and piloted by 2 independent reviewers (Cohen's κ .45-.73). The tool and corresponding protocol were used to systematically evaluate state DOH Web sites and related links.
  
  
  RESULTS
  Three categories of data were abstracted: (1) consumer-directed information intended to increase accountability of and competition between NH, including mandatory HAI reporting and NH inspection reports; (2) surveyor training for federally-mandated NH inspections; and (3) guidance for NH providers to prevent HAI and monitor incidence. Only 5 states included HAI reporting in NH with differing HAI types and reporting requirements.
  
  
  CONCLUSIONS
  State DOH information and activities focused on NH quality and reducing HAI were inconsistent. Systematically characterizing state DOH efforts to reduce HAI in NH is important to interpret the effects of these activities.
authors.affiliation: Columbia University School of Nursing, New York, NY. Electronic address: Chc2144@columbia.edu.
authors.forename: Catherine C
authors.initials: CC
authors.lastname: Cohen
authors.affiliation: Columbia University School of Nursing, New York, NY; Columbia University Mailman School of Public Health, New York, NY.
authors.forename: Carolyn T A
authors.initials: CT
authors.lastname: Herzig
authors.affiliation: Columbia University School of Nursing, New York, NY.
authors.forename: Eileen J
authors.initials: EJ
authors.lastname: Carter
authors.affiliation: Columbia University School of Nursing, New York, NY.
authors.forename: Monika
authors.initials: M
authors.lastname: Pogorzelska-Maziarz
authors.affiliation: Columbia University School of Nursing, New York, NY; Columbia University Mailman School of Public Health, New York, NY.
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Larson
authors.affiliation: Columbia University School of Nursing, New York, NY.
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Stone
mesh_terms: D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D006291:Health Policy; D006801:Humans; D017053:Infection Control / Q000379:methods*; D009735:Nursing Homes; D014481:United States / Q000453:epidemiology
keywords: Long-term care; Mandatory reporting; Public policy; Quality indicators; Quality report cards; Skilled nursing facility