Health & Medicine

Kentucky bill would require reporting of hospital-acquired infections

FRANKFORT — Kentucky hospitals would be required to report all infections patients acquire during hospital stays under a proposal pending before the state legislature.

Senate Bill 72, filed last week by Sen. Denise Harper Angel, D-Louisville, would also require all hospitals to implement infection prevention programs.

The cost of infections acquired during hospital stays is staggering, Harper Angel said. And more needs to be done to protect patients' health and save both patients and the health care system money.

"The cost of hospital acquired infections to Kentucky's health care system is estimated to be $392 to $462 million each year," Harper Angel said.

But Kentucky's hospitals strongly oppose the measure. The federal government already requires the reporting of hospital-acquired infections. Adding another system of reporting would be burdensome, said Nancy C. Galvagni, senior vice president of the Kentucky Hospital Association.

"There is no need for a new state mandate which would only add additional, unneeded costs on Kentucky's hospitals and state government," Galvagni said.

But Harper Angel and those who support the measure say the federal reporting requirements have not stopped hospital-acquired infections. Some say there could be as many as 1,400 deaths from hospital-acquired infections a year in Kentucky.

"Whatever is out there right now, is not working," Harper Angel said. "This appears to be out of control."

Harper Angel said she is open to hearing more about the hospitals' concerns.

Health care-associated infections are acquired while a patient is in a hospital and gets an infection not related to the reason the person is in the hospital. Some common types of hospital-acquired infections are urinary tract infections caused by catheters, pneumonia caused by ventilators and surgical wound infections.

Senate Bill 72 would require that hospitals send all data on hospital-acquired infections to the Cabinet for Health and Family Services. The reporting system would go into effect on July 1, 2012. Hospitals would also have to implement infection prevention programs for acute care areas such as surgical and intensive care units.

Facilities that fail to report will first get a citation but will be fined up to $1,000 a day for a second violation in six months and a fine of $20,000 for three or more violations within six months.

Dr. Kevin Kavanagh, a Somerset doctor, is a supporter of the bill.

"The CDC (Centers for Disease Control) estimates that ... almost one in 20 hospitalized patients (gets infected). In Kentucky, that means over 1,000 deaths and 23,000 infections," Kavanagh said.

Twenty-seven states require some form of hospital-acquired infection reporting, Kavanagh said.

But Galvagni of the Kentucky Hospital Association said that the federal government as well as state and national accreditation and licensing standards already require much of what SB 72 is trying to accomplish.

"The Centers for Medicare and Medicaid is requiring all acute care hospitals in the nation to begin reporting data on central line associated blood infection rates and surgical site infection rates," Galvagni said. "Hospitals that fail to do this will see a significant payment cut."

The Centers for Medicare and Medicaid oversee payments of Medicaid, the federal and state health care program for the poor and disabled, and Medicare, the health care program for people age 65 and older.

The data on central line associated bloodstream infections — infections typically caused by catheters and intravenous lines — began Jan. 1. Data on surgical site infections will begin Jan. 1, 2012, Galvagni said.

In addition, all hospitals have an infection control plan as part of their requirements for licensure and accreditation, Galvagni said.

But Harper Angel said reporting of data to state officials will help the state Department of Health better manage outbreaks and other infectious disease problems.

"Everyone seems to know someone this has happened to," Harper Angel said.

Harper Angel said it's not known yet how much it would cost to implement the bill. The legislature reconvenes Feb. 1.