HICPAC gives guidance on reporting nosocomial infections

April 2005

Although there is insufficient evidence to support or oppose public reporting of nosocomial infections, many states want to develop and implement reporting systems.

In response to the growing interest, the CDC’s Healthcare Infection Control and Prevention Advisory Committee (HICPAC) has researched the topic and now offers guidance for policy makers, program planners and consumer advocacy organizations tasked with planning and implementing mandatory public reporting systems of health care-associated infections.

To date, four states – Florida, Illinois, Missouri and Pennsylvania – have passed laws requiring hospitals to publicly report nosocomial infections. An additional 30 states are moving toward mandatory public release of this information.

“CDC believes that preventing health care-associated infections is a critical component of patient safety and an important public health issue,” said Denise Cardo, MD, director of the Division of Healthcare Quality Promotions at the CDC, during a teleconference.

HICPAC guidance

Patrick J. Brennan, MD, chair of HICPAC, said that the committee took a year to research the issue and come up with recommendations. He said that even with insufficient evidence for or against such reporting, specifically whether public reporting of health care–associated infections will reduce infection rates, the committee realizes that the process is moving forward and interest is increasing.

“While we have not made a recommendation for or against these processes, we are providing our consensus opinion on the best way to pursue the public disclosure of health care-associated infections,” Brennan said during the teleconference. “This document, then, is a guide to best practices; it is a consensus opinion of HICPAC, and we believe it is a starting point in the process.”

HICPAC recommended that states implementing public health reporting strive to gather meaningful infection control data and use nationally recommended infection control measures. To provide consumers and health care facilities with the best information, HICPAC recommends that states developing public reporting systems:

• Use established public health surveillance methods.
• Involve people with infection control expertise in the process.
• Track practices that prevent infections, in addition to measuring infection rates.
• Provide regular and confidential feedback to health care providers.

“We do not advocate the use of hospital discharge diagnostic codes as a primary data source for health care–associated public reporting systems,” Brennan added.

The CDC estimates that each year, nearly 2 million patients in the United States contract infections in hospitals, and about 90,000 of these patients die as a result of their infection. Bloodstream, urinary tract and surgical site infections as well as pneumonia account for most health care-associated infections.

The percentage of nosocomial infections that are preventable is unknown. However, the CDC believes that adherence to recommended infection control strategies can reduce infection rates substantially.

For more information:

• To view the guidance document, visit www.cdc.gov/ncidod/hip/PublicReportingGuide.pdf.