Federal Government Has Not Done Enough To Establish, Enforce Infection-Control Standards at Hospitals, According to GAO Report

The federal government has not established adequate guidelines to prevent hospital-acquired infections nor has it pushed hospitals to follow standards to reduce infections, according to a Government Accountability Office report released on Wednesday, the Baltimore Sun reports (Rockoff, Baltimore Sun, 4/17). The report, released during a House Oversight and Government Reform Committee hearing, had two principle recommendations: HHS should set "priorities" among hundreds of suggestions that CDC has made to prevent infections and incorporate them into requirements for participating in Medicare and Medicaid; and divisions of the department should be more collaborative in collecting and sharing data on hospital-acquired infection rates (Wayne, CQ Today, 4/16).

According to Consumers Union, about 90,000 U.S. residents die from hospital-acquired infections annually and an additional 1.9 million people acquire infections and are treated. According to the Sun, the deaths alone account for $5 billion in health care spending.

According to GAO, Medicare has not established enough standards for hospitals to prevent infections, and the standards they do have tend to be vague. Meanwhile, CDC has recommended 1,200 practices for preventing infections, of which 500 are strongly recommended. Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, said, "It feels like you're trying to walk through mud when you get volumes of recommendations." The report states that industry and physician groups offer more specific guidelines, such as requiring staff to receive influenza vaccines.

GAO recommendations include ensuring that staff wash their hands, increasing the use of antibacterial-coated medical devices and ensuring operating rooms are properly ventilated.

Federal officials acknowledged some of the shortcomings outlined in the report and said they are working to fix many of the problems, such as data collection on hospital-acquired infections. In addition, CMS this fall will no longer pay for the treatment of infections acquired at hospitals (Baltimore Sun, 4/17). Don Wright, deputy assistant secretary at HHS, at the hearing said, "We will make every effort to move forward with the recommendations as proposed by GAO" (CQ Today, 4/16).

A summary of the report is available online.