Study: Critical Access Hospitals Face Infection Control Challenges

A new study presented at the 45^th annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC) found that critical access hospitals (CAH) have serious infection control challenges. A CAH is defined by the Centers for Medicare & Medicaid Services (CMS) as a rural hospital with 25 beds or less that is located at least 35 miles away from other hospitals.

Public health officials reviewed infection prevention and control (IPC) practices at 36 Nebraska CAHs using the CDC’s IPC Assessment Tool. They found the largest gaps existed in the areas of injection safety, central line-associated bloodstream infection (CLABSI) prevention, and catheter-associated urinary tract infection (CAUTI) prevention, but problems were discovered in all IPC areas.

“Lack of competency-based training programs and failure to perform audits and feedback appear to be recurrent themes in several domains,” said lead study author Margaret Drake, MT(ASCP), DHHS, ICAP, in an APIC release. “These challenges are not unique to the facilities we visited. CAHs across the country face similar issues.”

A team of certified infection preventionists (IP) and public health officials visited each participating CAH, conducting assessments, audits, and observations focused on injection safety, and CLABSI and CAUTI prevention. A website was created to house frequently needed resources and tools. The study team noted that having trained IPs, allowing them to dedicate more time to infection control activities, and being a larger facility were factors tied to the presence of certain CDC-recommended IPC practices for CAHs.