According to (Cange, 2016), 1 out of 10 US hospital patients contract an infection during their hospital stay

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According to (Cange, 2016), 1 out of 10 US hospital patients contract an infection during their hospital stay, resulting in thousands of unnecessary deaths and billions of dollars in unnecessary costs. Centers for Medicare and Medicaid Services (CMS) uses two domains to measure the incidence of conditions for this program—the Agency for Healthcare Research and Quality’s Patient Safety Indicators (PSI-90) (Domain 1) and the National Healthcare Safety Network (NHSN) hospital-associated infection measures (Domain 2) (Sheetz & Ryan, 2020). Domain 2 constitutes 85% of the total score used to levy financial penalties against hospitals (Sheetz & Ryan, 2020). The PSI-90 composite is derived from Medicare claims; the NHSN measures are derived from an electronic registry managed by the Centers for Disease Control and Prevention (Sheetz & Ryan, 2020).

Almost all hospital acquired infections (HAI) are preventable, which is why CMS no longer reimburse hospitals for the costs to treat HAIs (Cange, 2016). These infections result in 100,000 deaths per year, making HAIs one of the top five causes of death in the United States. HAIs also cost US hospitals between $28 billion and $45 billion per year to treat (Cange, 2016). In 2016, not all hospitals were required to report HAIs, and some were excluded due to not performing the specific procedure that led to an HAI (Cange, 2016). These omissions limit the quantity and the completeness of the data, requiring researchers to make assumptions about HAI incidence which in turn continues to negatively impact the quality of patient outcomes (Cange, 2016).

Under the CMS reimbursement policy, eleven preventable adverse outcomes were identified: foreign objects retained after surgery, air embolism, blood incompatibility, stages III and IV pressure ulcers, falls and trauma, manifestations of poor glycemic control, catheter-associated urinary tract infections, vascular catheter-associated infections, surgical site infections, deep vein thrombosis, and iatrogenic pneumothorax with venous catheterization (Bae, 2016). Of these 11 patient outcomes, four (severe pressure ulcers, falls and trauma, catheter-associated urinary tract infections, and vascular catheter-associated infections) are considered nursing-sensitive quality outcomes that can be decreased with greater and better nursing care (Bae, 2016). Health care facilities are expected to make appropriate changes in patient care to improve these outcomes (Bae, 2016). Quality improvement initiatives can focus, for example, on patient safety or on care processes, and working conditions can be improved (Bae, 2016).

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References

Bae, S. (2016). The center for medicare & medicaid services reimbursement policy and nursing-sensitive adverse patient outcomes. Nursing Economics, 34(4), 161-171, 181.

Cange, J. R. (2016). Preventing hospital-acquired infections starts with data collection. Journal of AHIMA, 87(1), 44-46.

Sheetz, K. H., & Ryan, A. (2020). Accuracy of quality measurement for the hospital acquired conditions reduction program. BMJ Quality & Safety, 29(7), 605-607.

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