CMS targets antimicrobial resistance and hospital-acquired infection compliance

Significant bacterial infection can be cured with judicious and expedient use of appropriate antimicrobial agents, notably antibiotics.

However, repetitive short-term exposure to antibiotics and random mutation of bacteria have resulted in resistant bacterial organisms, with few options for cure.

The long-term consequences of bacterial resistance to antibiotics is increased morbidity and mortality and increased healthcare costs. To mitigate these outcomes, the U.S. Centers for Medicare & Medicaid Services has implemented requirements regarding proper antibiotic use. The centers also are scrutinizing healthcare organizations based on new requirements focusing on resistant infections that initially occur in the hospital setting.

Infections due to Clostridium difficile, commonly called “C. diff,” and methicillin-resistant Staphylococcus aureus, known as MRSA, are specifically targeted by the CMS, as they place a large burden on patients and the healthcare system and have a propensity to be acquired during an inpatient stay.

The penalties may result in up to 1% in reduced reimbursements from CMS for some institutions. This could cost them an estimated $430 million in 2016, making reduction of these organisms a major priority of many health systems, according to a Healthcare IT News article.

How can healthcare professionals address these infection issues?

The control of resistant microorganisms is a responsibility of everyone in a healthcare setting. Collaboration and communication among key members is essential to ensure reporting is uniform, and developed policies are appropriately designed and carried out.

First, education is necessary across the board, involving not only healthcare team members but also administrators, staff and patients. With all members having a better understanding of their role and a basic knowledge of the transmission of these organisms, the ability to track and control organisms becomes easier.

A 15% decrease in antibiotic use may be needed to decrease misuse by half, according to a recent CMAJ article, “Antibiotic overprescribing is a growing problem.” Appropriate hand hygiene, facility management and modes of infection transmission must be identified and addressed to reduce the spread of disease within the healthcare setting.

As with many medical issues, preventive measures are key to infection control. Policies and procedures should be developed that consider everything from patient transport to food services, to ensure minimal risk of microbial spread. Hand sanitization, gowning and medicine preparation are practices that should be evaluated and consistently targeted.

Finally, a dedicated means of gathering data, reviewing it and using it to develop and evaluate ways to continuously improve should be put into place.

With everyone better understanding their role in preventing the acquisition of these infections, improved reporting and institutional policies can be designed and implemented.

The overall impact on the healthcare system would be positive as patients are at a reduced risk of acquiring resistant and potentially lethal infections, and hospitals experience reductions in admissions and excessive costs.