Health-Care-Associated Infections in Hospitals: An Overview of State Reporting Programs and Individual Hospital Initiatives to Reduce Certain Infections

Health-care-associated infections (HAI) are infections that patients acquire while receiving treatment for other conditions. Normally treated with antimicrobial drugs, HAIs are a growing concern as exposure to multidrug-resistant organisms (MDRO) becomes more common. Infections caused by MDROs, such as methicillin-resistant Staphylococcus aureus (MRSA), lead to longer hospital stays, higher treatment costs, and higher mortality. In response to demands for more public information on HAIs, some states began to establish HAI public reporting systems. The federal Centers for Disease Control and Prevention (CDC) developed a system--the National Healthcare Safety Network (NHSN)--to collect HAI data from hospitals and some states have chosen to use it for their programs. In addition, some hospitals have adopted initiatives to reduce MRSA by routinely testing some or all patients and isolating those who test positive for MRSA from contact with other patients. GAO was asked to examine (1) the design and implementation of state HAI public reporting systems, (2) the initiatives hospitals have undertaken to reduce MRSA infections, and (3) the experience of certain early-adopting hospitals in overcoming challenges to implement such initiatives. GAO interviewed state officials, reviewed documents, and surveyed or conducted site visits at hospitals with MRSA-reduction initiatives.