Healthcare-associated infections and sepsis mortality are important public health problems. It has been shown many times that strategies to reduce NI can significantly improve the situation. In the US, since 2012, a reform of the healthcare system has allowed hospitals to implement infection prevention strategies with incentive payments to reduce both NI and sepsis mortality. The authors of a study published in 2021 took the opportunity to conduct a prospective observational study on quality improvement in a 770-bed public academic hospital in Texas (USA) from 2013 to 2017 . Because of its participation in the government-funded programme, the hospital was able to implement a predefined set of interventions. These included an awareness campaign (e.g. newsletters, screensavers, sharing of surveillance data), clinician engagement (e.g. lunch seminars, focus group meetings), implementation of NI and sepsis bundles, training of clinical staff on the bundles, training of managers and staff in quality improvement methods, and clinical decision support through electronic health records.
Infection rates and sepsis mortality were significantly reduced
For the 5-year study period, vascular catheter-associated bloodstream infections (BSI), catheter-associated urinary tract infections (UTI), postoperative wound infections (surgical site infections, SSI) and sepsis mortality were defined as primary endpoints. Data were collected by trained hygienists by reviewing electronic medical records. This showed that overall infection rates were significantly reduced over the period. For example, 73% fewer UTIs, 52% fewer BSIs and 62% fewer SSIs were recorded in 2017 than in 2013, and the unadjusted mortality rate for patients with suspected sepsis was reduced by 69%. All these effects were statistically significant.