Factors associated with a significant reduction in hospital-wide infection rates

Abstract

Objective: The purpose of this study was to identify factors associated with a significant reduction in hospital-wide nosocomial infection rates. Methods: Methods included a 3-year retrospective and a 10-month prospective follow-up study in a 500-bed hospital with total surveillance, with data collected by two ICPs using Centers for Disease Control and Prevention (CDC) definitions. Results: Infection rates averaged 3.9% over a decade and dropped in 1993 to 2.6% ( p < 0.001). This change was unexplained by changes in surveillance methods. Slightly shorter lengths of stay and fewer inpatient surgeries may have had some impact. Additionally, two factors were temporally and statistically associated with the reduction: hospital-wide introduction of the Occupational Health and Safety Administration (OSHA) Blood-borne Pathogen Exposure Control Plan and Body Substance Isolation and a barrier hand foam. Conclusions: Introduction of the OSHA Control Plan, with concomitant increase in glove use and widespread use of a barrier hand foam were associated with a significant reduction in nosocomial infection rates. Other demographic variables (shorter hospital stays and less inpatient surgery) probably also played a role. Risk-adjusted rates are necessary to make within-hospital comparisons over time.