Final
Report on Hospital-Acquired Infections
HEALTH CARE TASK FORCE
Votes:
Action Taken:
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11:07 AM -- Report on Hospital-Acquired Infections
Susan Dolan, President of the Association for Professionals in Infection Control and Epidemiology (APIC), distributed a handout of her powerpoint presentation entitled, "Mandatory Reporting and Public Disclosure of Healthcare Associated Infections" (Attachment B) and talked about hospital acquired infections. Ms. Dolan explained that hospital acquired infections are ones that patients do not come in with, rather they acquire them at the hospital. Senator Keller asked how the hospital knows the infection was not dormant. Ms. Dolan stated that there are certain criteria to determine if it was acquired in the hospital, including the review the patient's chart, looking at information in their medical records, and talking with the patient as well. Senator Keller asked how often the infections are caused by improperly sterilized tools to which Ms. Dolan explained it varies, they have tried to mechanically disinfect but if they are rushed, a step in properly cleaning a tool can be skipped. Senator Keller asked if there are designated staff in charge of only sterilizing tools. Ms. Dolan stated they do have sterile processing department staff that handle sterilization, and that those staff are certified. Senator Keller asked if there was uniform certification and, if not, is there a need for it. Ms. Dolan stated there are standards, but no mandatory certification is required and that it would help if there were uniformity, such as a national standard, but it takes a long time to pass federal legislation so the states have picked it up. Ms. Dolan explained that the APIC is in support of public reporting of hospital acquired infection data so the consumer can make an educated decision on which hospital to attend.
Senator Tochtrop asked if the APIC takes into consideration the ratio of professional staff when they look at studies and whether that correlates with the rate of hospital acquired infections. Ms. Dolan responded by explaining the APIC does not do use staffing ratios, but there are currently definitions provided to the APIC to determine the rate of hospital acquired infections. She added that these definitions provide numerators that tell them how to determine if the infection occurred in the hospital and denominators that are based on individual things, such as, the amount of surgeries performed and risk adjustment depending on the type of surgery.
11:24 AM
Ms. Dolan continued her discussion about a national standard and the role that APIC will play in developing this standard. She discussed the issue of the state creating a standard and then possibly a national standard being developed later. She talked about what the APIC is looking at regarding what to report related to infection rates, and what data will be relevant to the stake-holders such as the hospitals. She stated that high risk areas are the ones that need to be focused on when developing a standard.
Ms. Dolan discussed some of the challenges to developing an infection standard. She talked about the possibility that a provider may turn away high risk patients in order to avoid having bad numbers associated with their facility. Senator Keller asked whether states with infection reporting requirements have any data about providers turning patients away. Ms. Dolan stated that this information was more anecdotal than statistically based.
11:33 AM
Ms. Dolan discussed a bill sponsored by Representative McCluskey in the 2005 session (HB 05-1128). She stated that if this bill idea is attempted again, issues that should be looked at include: timing of the reporting, the timing of releasing the data to the public, allowing a task force to study the issues, educating providers on how to accurately report, and providing adequate funding for the reporting.
Representative McCluskey commented on Ms. Dolan's presentation. He thanked The Children's Hospital for their involvement in the 2005 bill. He added that timing issues in the bill do need to be looked at, and that Colorado should review the experiences in other states when drafting a new bill for 2006. He added that he was not comfortable in waiting for the federal government to implement an infection reporting standard.
11:42 AM
Senator Keller asked whether anyone was present to provide public testimony on the issue of hospital infections. David Cassidy, representing himself, commented on the issue of hospital-acquired infections and distributed a handout that included the fiscal note from Representative McCluskey's bill and some newspaper articles that discussed hospital acquired infections (Attachment C). He spoke about the fiscal notes that were prepared for HB 05-1128, and stated that it is important to pass a bill that requires hospitals to report all hospital-acquired infections that occur. He discussed a personal experience he had with a hospital-acquired infection. Representative McCluskey thanked Mr. Cassidy for coming, and encouraged him to be involved with a bill in 2006.
12:01 PM
Senator Keller polled the members about their schedules and the committee decided to work into lunch in order to catch up on the agenda.