Notice2022-24822
Notice for Public Comments on Healthcare-Associated Infections (HAI) National Action Plan Targets
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Published
November 15, 2022
Issuing agencies
Health and Human Services Department
Abstract
The Department of Health and Human Services' (HHS) Office of Infectious Disease and HIV/AIDS Policy (OIDP) in the Office of the Assistant Secretary for Health (OASH) announces the draft targets for updating the Healthcare-Associated Infections (HAI) National Action Plan, Phase 1, Acute Care Hospitals, for public comment. The HHS Core Group of the HAI National Action Plan reviewed data pre-pandemic and between 2020 and 2021 and developed potential 5-year targets based on assumptions that current HAI rates should return to pre-pandemic baseline rates within 2 years or within 3 years when determining these 5-year targets. The HHS HAI NAP Core Group recommends 5-year targets assuming a return to pre-pandemic baseline rates within 3 years based on two fundamentals: (1) pandemic-related challenges will likely persist in upcoming years, and (2) the pandemic has caused major strains on the health care system which make a 3-year timeline to achieve pre-pandemic Standardized Infection Ratio (SIR) the most appropriate choice. The draft targets are below.
Full Text
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<title>Federal Register, Volume 87 Issue 219 (Tuesday, November 15, 2022)</title>
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[Federal Register Volume 87, Number 219 (Tuesday, November 15, 2022)]
[Notices]
[Page 68506]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-24822]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Notice for Public Comments on Healthcare-Associated Infections
(HAI) National Action Plan Targets
AGENCY: Office of Infectious Disease and HIV/AIDS Policy, Office of the
Assistant Secretary for Health, Department of Health and Human
Services, Office of the Secretary, Department of Health and Human
Services.
ACTION: Notice for public comment.
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SUMMARY: The Department of Health and Human Services' (HHS) Office of
Infectious Disease and HIV/AIDS Policy (OIDP) in the Office of the
Assistant Secretary for Health (OASH) announces the draft targets for
updating the Healthcare-Associated Infections (HAI) National Action
Plan, Phase 1, Acute Care Hospitals, for public comment. The HHS Core
Group of the HAI National Action Plan reviewed data pre-pandemic and
between 2020 and 2021 and developed potential 5-year targets based on
assumptions that current HAI rates should return to pre-pandemic
baseline rates within 2 years or within 3 years when determining these
5-year targets. The HHS HAI NAP Core Group recommends 5-year targets
assuming a return to pre-pandemic baseline rates within 3 years based
on two fundamentals: (1) pandemic-related challenges will likely
persist in upcoming years, and (2) the pandemic has caused major
strains on the health care system which make a 3-year timeline to
achieve pre-pandemic Standardized Infection Ratio (SIR) the most
appropriate choice. The draft targets are below.
DATES: All comments must be received by 5:00 p.m. ET on January 13,
2023, to be considered.
ADDRESSES: All comments must be submitted electronically to <a href="/cdn-cgi/l/email-protection#236c6a67730e6b626a634b4b500d444c55"><span class="__cf_email__" data-cfemail="06494f42562b4e474f466e6e7528616970">[email protected]</span></a> to be considered.
FOR FURTHER INFORMATION CONTACT: Chinedu R. Okeke, OIDP, Medical
Officer at <a href="/cdn-cgi/l/email-protection#12717a7b7c7776673c7d79777977527a7a613c757d64"><span class="__cf_email__" data-cfemail="87e4efeee9e2e3f2a9e8ece2ece2c7efeff4a9e0e8f1">[email protected]</span></a> or 202-868-8872.
SUPPLEMENTARY INFORMATION: Healthcare Associated Infections (HAIs) are
infections that patients get while receiving care or treatment, and
many HAIs are preventable. Modern healthcare employs many types of
invasive devices and procedures to treat patients and to help them
recover. Infections can be associated with surgeries and the devices
used in medical procedures, such as catheters or ventilators and due to
the transmission of pathogens. HAIs are an important cause of morbidity
and mortality in the United States and are associated with a
substantial increase in healthcare costs each year. At any given time
in the US, 1 out of every 31 hospitalized patients are affected by an
HAI. HAIs occur in all types of care settings, including acute care
hospitals, ambulatory surgical centers, dialysis facilities, outpatient
care, and long-term care facilities. The updates here are for phase 1
of the action plan, which focuses on acute care hospitals.
HAIs are a significant source of complications across the continuum
of care and can be transmitted between different healthcare facilities.
However, recent studies suggest that implementing existing prevention
practices can lead up to a 70 percent reduction in certain HAIs.
Likewise, recent modeling data suggests that substantial reductions in
resistant bacteria, like MRSA, can be achieved through coordinated
activities between healthcare facilities in each region. The financial
benefit of using these prevention practices is estimated to be $25
billion to $31.5 billion in medical cost savings. Risk factors for HAIs
can be grouped into three general categories: medical procedures and
antibiotic use, organizational factors, including risks for pathogen
transmission, and patient characteristics. The behaviors of health care
providers and their interactions with the health care system also
influence the rate of HAIs.
To provide a roadmap for HAI prevention, HHS released the National
Action Plan to Prevent Health Care-Associated Infections: Roadmap to
Elimination (HAI National Action Plan) in 2009 with updates to phase 1,
acute care hospitals made in 2013 and 2018. In 2020, HHS leadership
transitioned the HAI portfolio to the Office of Infectious Disease and
HIV/AIDS Policy (OIDP). To date, OIDP is the lead for the federal
steering committee and charged with leading the process to update the
HAI National Action Plan. Due to the COVID-19 pandemic, HHS and
implementing agencies delayed the process of updating the national
action plan and indicator targets for HAIs in acute care hospitals due
to data instability. This proposed update would include new indicator
targets for certain HAIs in acute care hospitals.
Goals
All Goals Are Five-Year Goals With the Baseline Year Being 2023 and the
Goal Year Being 2028
<bullet> Reduce central line-associated bloodstream infections (CLABSI)
in intensive care units and ward-located patients by 40% from 2023-2028
<bullet> Reduce catheter-associated urinary tracts infections (CAUTI)
in intensive care units and ward-located patients by 25% from 2023-2028
<bullet> Reduce hospital-onset MRSA bacteremia by 40% from 2023-2028
<bullet> Reduce hospital-onset Clostridioides difficile infections
(CDI) by 20% from 2023-2028
Of note, the previous iteration of the HAI national action plan
included targets for reducing surgical site infections (SSI). However,
during the period of 2020-2022, there has been significant data
instability for SSI due to variable surgical volume related to deferral
of elective surgeries in hospitals undergoing COVID surges. The HAI
national action plan Core Group therefore decided not to establish
targets for SSI at this time.
Information Needs
HHS seeks to obtain feedback from external stakeholders on the
following:
1. Are the draft targets realistic and achievable?
2. Are there any critical gaps in the draft targets? If so, please
specify the gaps.
3. Do you have any concerns about the targets? If so, please
specify, and describe the concern regarding it.
Each commenter is limited to a maximum of seven pages.
Dated: November 2, 2022,
B. Kaye Hayes,
Deputy Assistant Secretary for Infectious Disease, Director, Office of
Infectious Disease and HIV/AIDS Policy, Executive Director,
Presidential Advisory Council on HIV/AIDS, Office of the Assistant
Secretary for Health, Department of Health and Human Services.
[FR Doc. 2022-24822 Filed 11-14-22; 8:45 am]
BILLING CODE 4150-44-P
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