Background
Currently, most US states have adopted legislation requiring hospitals to submit health
care–associated infection (HAI) data. We evaluated the perceived impact of state HAI
laws on infection prevention and control (IPC) departments.
Methods
A web-based survey of a national sample of all non-veteran hospitals enrolled in the
National Healthcare Safety Network was conducted in fall 2011. Variations in IPC department
resources and characteristics in states with and without laws were compared by use
of χ², Mann-Whitney (Wilcoxon), and Student t tests. Multinomial logistic regression
was used to identify increases or decreases, versus no change, in perceived resources,
time, influence, and visibility of the IPC department in states with and without HAI
laws.
Results
Overall, 1,036 IPC departments provided complete data (30% response rate); 755 (73%)
were located in states with laws. Respondents in states with reporting laws were more
likely to report less time for routine IPC activities (odds ratio, 1.61; 95% confidence
interval, 1.12-2.31) and less visibility of the IPC department (odds ratio, 1.70;
95% confidence interval, 1.12-2.58) than respondents in states without laws, after
controlling for geographic region, setting, and the presence of a hospital epidemiologist.
Conclusions
Respondents in states with laws reported negative effects on their IPC department,
beyond what was required by federal mandates. Further research should examine resources
necessary to comply with state HAI laws and evaluate unintended consequences of state
HAI laws.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Infection ControlAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Multistate point-prevalence survey of health care–associated infections.JAMA. 2014; 370: 1198-1208
- State-mandated reporting of health care-associated infections in the United States: trends over time.Am J Med Qual. 2015; 30: 417-424
- (Hospital Inpatient Quality Reporting Program. Available from:) (Accessed May 16, 2018)
- Laws pertaining to healthcare-associated infections: a review of 3 legal requirements.Infect Control Hosp Epidemiol. 2012; 33: 75-80
- The impact of public reporting on clinical outcomes: a systematic review and meta-analysis.BMC Health Serv Res. 2016; 16: 296
- Influence of state laws mandating reporting of healthcare-associated infections: the case of central line-associated bloodstream infections.Infect Control Hosp Epidemiol. 2013; 34: 780-784
- The association of state legal mandates for data submission of central line-associated bloodstream infections in neonatal intensive care units with process and outcomes measures.Infect Control Hosp Epidemiol. 2014; 35: 1133-1139
- The effect of mandated quality reporting on outcomes and on reporting: evidence from infection reporting in Pennsylvania.Northwestern Law and Econ research paper. 2018; (no. 11–19. Available from:) (Accessed May 16, 2018)
- Impact of state reporting laws in central-line associated bloodstream infection rates in U.S. adult intensive care units.Health Serv Res. 2017; 52: 1079-1098
- California hospitals response to state and federal policies related to health care-associated infections.Policy Polit Nurs Pract. 2011; 12: 73-81
- Translating and scaling the HHS Action Plan to Prevent Healthcare-Associated Infections to the local level: experience of a Los Angeles Health System.Med Care. 2014; 52: S60-S65
- Lessons learned while implementing mandatory health care-associated infection reporting in New York State.J Public Health Manag Pract. 2013; 19: 294-299
- Assessment of the burden of mandatory reporting of health care-associated infection using the National Healthcare Safety Network in Massachusetts.Am J Infect Control. 2013; 41: 466-468
- Guidance on public reporting of health care-associated infections: recommendations of the Healthcare Infection Control Practices Advisory Committee.Infect Control Hosp Epidemiol. 2005; 26: 580-587
- Exploring infection prevention: policy implications from a qualitative study.Policy Polit Nurs Pract. 2011; 12: 82-89
Szymczak JE. How mandatory public reporting undermined IP: an ethnographic study of HAI surveillance and public reporting [abstract 906]. Program and abstracts of the 2014 Meeting of the Infectious Diseases Society of America (ID Week); 2014 Oct 8-12; Philadelphia, PA.
- State of infection prevention in US hospitals enrolled in the National Health and Safety Network.Am J Infect Control. 2014; 42: 94-99
- Infection control resources in New York State hospitals, 2007.Am J Infect Control. 2008; 36: 702-705
- Tensions inherent in the evolving role of the infection preventionist.Am J Infect Control. 2013; 41: 959-964
- Impact of laws aimed at healthcare-associated infection reduction: a qualitative study.BMJ Qual Saf. 2015; 24: 637-644
- Public reporting of hospital-acquired infections is not associated with improved processes or outcomes.Infect Control Hosp Epidemiol. 2013; 34: 844-846
Article info
Publication history
Published online: October 12, 2018
Footnotes
Previous presentation: Presented at IDWeek 2014 as a poster entitled “The Impact of State Mandated Healthcare-Associated Infection Reporting on Infection Prevention and Control Departments in Acute Care Hospitals: Results From a National Survey.”
Funding/support: This work was supported by the National Institute of Nursing Research at the National Institutes of Health (R01 NR010107, PI: P.W. Stone) and from the Agency for Healthcare Research and Quality (1K08HS024339-01) Mentored Clinical Scientist Research Career Development Award. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health and the Agency for Healthcare Research and Quality. The study sponsor had no role in the design or conduct of the study; in the collection, analysis, or interpretation of the data; in the writing of the manuscript; or in the decision to submit the manuscript for publication.
Conflicts of interest: None to report.
Identification
Copyright
© 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
