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Home Divisions Epidemiology and Response Infectious Disease Epidemiology Healthcare-Associated Infections

Healthcare-associated Infections Program

Healthcare-associated Infections (HAI) are infections that people get while in a healthcare facility or while receiving medical care. According to Center for Disease Control and Prevention (CDC), HAI can be associated with the use of medical devices like catheters and ventilators, transmission between patient and healthcare workers, or complications following a surgical procedure. According to the Agency for Healthcare Research and Quality (AHRQ), HAI are one of the top 10 causes of death in the US, and they are the most common complication of healthcare. But most HAI can be avoided with the ultimate goal of being eliminated by following evidence-based prevention guidelines.

New Mexico is working to identify and reduce the prevalence of HAI in the state. On this website, there are reports, resources, and tools to educate and inform healthcare providers and the public on these common topics.

Table of Contents

History

The New Mexico HAI Advisory Committee was formed in 2009, and a pilot study was conducted to test the feasibility of conducting surveillance for HAI in New Mexico. The HAI pilot included six hospitals located in Albuquerque, Alamogordo, Farmington, and Las Cruces that voluntarily submit data about the number of central line-associated bloodstream infections in their adult intensive care units and influenza vaccination of their healthcare workers. Please see the Healthcare-Associated Infections Pilot Report 2009 for results of this pilot project

In 2009 The Hospital-acquired Infection Act, NMSA 1978 §§ 24-29 (2009) was enacted which formalized the New Mexico HAI Advisory Committee and its role while keeping HAI data submission voluntary in New Mexico. The Committee is facilitated by the New Mexico Department of Health and is currently working toward its goals related to public reporting and prevention of HAI.

In January 2010 the New Mexico HAI Advisory Committee submitted the New Mexico Healthcare-Associated Infections Prevention Plan. The Plan provides for standardized data submission and for implementation of best practices to prevent HAI in New Mexico healthcare facilities and is regularly updated.

As progress on the Prevention Plan continues, more facilities are submitting HAI data voluntarily, and the New Mexico HAI Program will continue to identify and expand prevention efforts in New Mexico.

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Prevention

According to the CDC, HAI are severe and impact many lives every year, approximately 1.7 million HAI occur in healthcare facilities each year, resulting in 99,000 deaths. Some of these infections can be avoided. Healthcare facilities in New Mexico are working towards identifying and reducing these infections. Many New Mexico healthcare facilities are focusing on improving practices to reduce central-line associated bloodstream infections (CLABSI) and to reduce transmission of Clostridium difficile infections (an infection of the colon commonly related to antibiotic use in both community and healthcare settings). Healthcare facilities are also working to improve influenza immunization rates of healthcare workers, which reduces the risk of patients being exposed to flu while they are already ill.

Below you will find information on how you can help. It is vital that everyone works together to improve the safety of our healthcare system. Thank you for visiting our website and wanting to learn more.

Hand Hygiene

Hand hygiene is a simple yet effective way to prevent infections. Cleaning your hands can prevent the spread of germs, including those that are resistant to antibiotics and are becoming difficult, if not impossible, to treat.

For more information about hand hygiene, please visit:

Partnership with Your Providers

Healthcare providers know they should practice hand hygiene, but they sometimes forget. Most welcome your friendly reminder. Ask healthcare providers to practice hand hygiene - tell them that you know that infections can be acquired in a healthcare setting and that you don’t want it to happen to you.

Cover Your Mouth and Nose

Cough and sneeze into a tissue (disposed of properly), or into your elbow.

Get Vaccine to Avoid Disease

Keep all your immunizations up to date. Get vaccine to avoid disease and fight the spread of infection.

Visit the Vaccines Federal Information Gateway to educate yourself on immunization and the best ways to protect yourself and your family from infectious diseases.

If You Are Sick

If you are sick, avoid close contact with others.  Do not visit friends and family in a healthcare facility, because you can unintentionally give them your illness.

Hospitalization

If you or a loved one is hospitalized, there are steps you can take to lower the risk of HAI transmission.

  • Make sure you wash your hands.
  • Ask the hospital staff to do the same before and after they provide care, such as changing bandages.
  • Tell the nurse if you notice that bandages are not clean, dry, or covering any open wounds.
  • Tell your friends and family members to avoid hospital visits if they have a cold or aren't feeling well.
  • Don't be afraid to speak up.

See the Ten Things You Can Do to Be a Safe Patient page for more information on steps to take when hospitalized.

Get Smart about Antibiotics

  • Take your antibiotics exactly as prescribed.
  • DO NOT take antibiotics for viral infections (e.g., cold, flu, or norovirus).
    • Ask your healthcare provider about the best way to feel better while your body fights off the virus.
  • Do not share, skip or save your antibiotics.
  • Avoid getting sick by washing your hands, covering your mouth while coughing, and remembering to get the flu vaccines.

For more information about antibiotic uses and prescribing, please visit the Antibiotics Awareness website.

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Antibiotic Resistant and Antibiotics Stewardship

Antibiotic Resistant

Antibiotics are a key tool in preventing, treating and eliminating bacterial diseases in both humans and animals. Antibiotics are only needed for treating certain infections caused by bacteria. According to the CDC, due to the overuse and misuse of antibiotics, antibiotic resistance has become one of the most urgent public health threats. Antibiotic resistance occurs when bacteria no longer respond to the drugs designed to kill them. Each year in the United States, at least 2 million people become infected with multi-drug resistant bacteria (resistant to 3 or more classes of antibiotics) that are resistant to antibiotics, and at least 23,000 people die each year as a direct result of this infection.

Anytime antibiotics are used, it can cause side effects and lead to antibiotic resistance.  When antibiotics are not needed, it will not help you get better, and the side effects could still hurt you. Common side effects range from things like rashes and yeast infections to severe health problems like Clostridium difficile infection (also called C. difficile or C. diff or CDI), which causes diarrhea that can lead to severe colon damage and death.

Antibiotic Stewardship

Antibiotic stewardship refers to a set of coordinated strategies to improve the use of antibiotic medications with the goal of enhancing patient health outcomes, reducing resistance to antibiotics, and decreasing unnecessary costs. The goal of antibiotic stewardship is to support the collaboration with different partners in order to develop and evaluate stewardship activities in healthcare facilities, to provide data about antibiotic use and to better understand the trends of prescribing practices of healthcare practitioners better. HAI program expanding their HAI Antibiotic Resistance prevention programs to help implement best practices around improving antibiotics prescribing and to support early recognition of sepsis. For more information about Antibiotic Stewardship, please visit the Antibiotic Stewardship website.

Carbapenem-resistant Enterobacteriaceae

Carbapenem-resistant Enterobacteriaceae (CRE) are a family of bacteria that are highly resistant to carbapenem antibiotics (i.e., ertapenem, doripenem, imipenem, and meropenem). Carbapenem are used as the last line of antibiotics and are often more difficult or impossible to treat. CRE is an important emerging threat to public health. CRE is typically spread from touching an infected person’s infected bodily fluids (blood, drainage from a wound, urine, stool or sputum) or from a contaminated environment. In a healthcare setting, it can spread from the hands of healthcare personnel, through contact with contaminated surfaces, or an improperly cleaned patient care equipment. It is not spread through the air or casual contact, such as touching or hugging.

Prevention

To prevent the spread of CRE, the public, healthcare personnel, and facilities can follow infection control precautions. These includes:

  • Washing hands with soap and water or an alcohol-based hand sanitizer before and after caring for a patient
  • Properly clean and disinfect rooms and medical equipment
  • Wear the appropriate PPE like gloves, and/or gowns before entering the room of a CRE patient
  • Keeping patients with CRE infections in a single room or sharing a room with someone else who has the exact same kind of CRE infection

Carbapenemase-producing CRE

Carbapenemase-producing CRE (CP-CRE), are Enterobacteriaceae that possess resistance genes code for plasmid-mediated carbapenemases that can be exchanged between different gram-negative bacteria. They are an emerging public health problem in the United States that have spread rapidly, with cases reported in all 50 states. CP-CRE are the most concerning CRE because of their ability to transfer their resistance genes between different genera of Enterobacteriaceae and are associated with high mortality rates.

CRE Surveillance and Case Definition and Reporting

Starting June 1, 2016, CRE became reportable statewide under the Notifiable Conditions and Diseases in New Mexico. To report CRE to the NMDOH, please fill out this CRE Case Report Form and submit it to us.

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Initiatives

Multiple HAI initiatives are underway in New Mexico; some of which are operating statewide and others focused on specific healthcare facilities. Some of the initiatives include Infection Control Assessment and Response (ICAR), Injection Safety and Antimicrobial Stewardship Extension for Community Healthcare Outcomes (ECHO) project, HAI Reporting Group, Targeted Assessment for Prevention (TAP) Strategy, and Emerging Infections Program (EIP).

For more information, please contact us at our hai.program@doh.nm.gov email address.

Infection Control Assessment and Response

This is a CDC funded program at the NMDOH focused on supporting state-driven efforts to improve infection control and prevention capacity. ICAR is a collaborative approach to assess the strength of infection prevention practices in healthcare facilities and guides quality improvement activities by addressing identified gaps.

The goal of ICAR is to improve the current landscape of infection control policies and practices in healthcare settings and help reduce the infection rate across New Mexico.

If you are interested in the voluntary and non-punitive review of infection control policies and practices in your healthcare facility, please contact the HAI Epidemiologist Holly Simpson at her 505-827-2914 phone number. For more information on ICAR, please visit the Infection Control Assessment and Response website.

Injection Safety

Injection safety or safe injection practices refers to the measures taken to perform injections in the safest possible manner. NMDOH joins CDC’s One and Only Campaign to promote safe injection practices around New Mexico. One and Only Campaign is a public health effort to eliminate unsafe medical injections. Through targeted education and awareness efforts, the One & Only Campaign empowers patients and healthcare providers to insist on nothing less than safe injections. For more information about injection safety and educational materials, please visit the New Mexico One and Only Campaign, Injection Safety FAQs for Patients, and Information for Health Professionals on Injection Safety websites.

Antimicrobial Stewardship ECHO Project

Infectious Disease and Epidemiology Bureau, is facilitating the Antimicrobial Stewardship Extension for Community Healthcare Outcomes (ECHO) project; it is a collaboration between NMDOH and the University of New Mexico Health Sciences. The curriculum is intended to engage pharmacists, infection control practitioners, and healthcare providers from hospitals around New Mexico in implementation and development of inpatient antimicrobial stewardship programs. The intent is to provide knowledge and best practice recommendations around Antibiotic Stewardship through case-based learning and didactic sessions to hospital pharmacists and others who lack expertise in Antibiotic Stewardship or wish to sharpen their skills and stay up to date on the latest strategies.  For more information about Echo Project for antibiotic stewardship visit the Antimicrobial Stewardship website.

New Mexico HAI Reporting Group

The purpose of the New Mexico HAI Reporting Group is to promote the voluntary healthcare facility data reporting.

The program encourages enrollment of New Mexico healthcare facilities for voluntary data submission on specified HAI indicators. The data submitted by healthcare facilities will be used in support of collaborative solutions at the healthcare facility level to decrease HAI, improved NMDOH HAI surveillance and response capacity, and consumer needs for HAI-related information.

The Healthcare-associated Infections Reporting Group List of Participating Facilities map provides a comprehensive list and map of participating facilities. These participating reporting facilities in New Mexico currently represent all of the various Public Health Regions in the state.

Reportable Infections

  • Adult & pediatric ICU Central Line-associated Bloodstream Infections (CLABSI)
  • Non-ICU CLABSI
  • MRSA
  • CDI infections

Benefits

  • Standardized HAI data submission using National Healthcare Safety Network (NHSN), a federally supported electronic database mandated for Centers for Medicare & Medicaid Services HAI reports beginning January 2011.
  • Receive surveillance and data reporting support from NMDOH.
  • Maximize healthcare facility resources through efficient surveillance systems, improved prevention practices, and reduced infection rates.
  • Influence regulatory process related to HAI reporting.

Expectations

  • Enroll in NHSN or other specified data systems for data submission of New Mexico HAI Program Indicators.
  • Submit data per specified timelines.
  • Inclusion in aggregated and, as of July 2011, facility-specific public reporting of indicators.

Targeted Assessment for Prevention Strategy

Targeted Assessment for Prevention (TAP) Strategy is a framework for quality improvement that offers a focused approach to infection prevention for healthcare facilities, healthcare systems, public health, and quality improvement partners. This strategy can be used to identify facilities and units with a high burden of HAI so that specific gaps in infection prevention can be identified and addressed. The TAP strategy incorporates the TAP reports generated in CDC’s NHSN to along with standardized assessment tools and accompanying implementation strategies.

TAP strategy consists of the HAI program:

  • Running TAP report in NHSN to target healthcare facilities with an excess burden of HAI like CDI, CAUTI, and CLABSI.
  • Interpreting TAP report to target specific units within a healthcare facility. This is achieved by understanding the Cumulative Attributable Difference (CAD) metric. CAD is the number of infections that must be prevented to achieve the HAI reduction goal.
  • Communicating TAP report data to engage facility leadership and administrators
  • Assessing TAP facility assessment tools to identify gaps in infection prevention in the different target location.
  • Implementing infection prevention strategies. This is achieved by summarizing results from the facility assessment tool administered to staff members within the identified units, and facilities to aid in identifying domains and areas of improvement to address.

For more information on specific TAP report, please visit the Patient Safety Analysis Quick Reference Guides page and more information on TAP Strategy, please visit the Target Assess Prevent Strategy website.

Emerging Infections Program for HAI

The EIP HAI Community Interface (HAIC) is a network of state health departments and academic partners funded by the CDC. New Mexico is one of 10 EIP HAIC sites across the United States.

One of the primary activities of EIP HAIC is to conduct surveillance for emerging HAI. The HAI component of CDC’s EIP engages a network of state health departments and their academic medical center partners in helping answer critical questions about emerging HAI threats, advanced infection tracking methods, and antibiotic resistance in the United States. Information gathered through this activity will play a key role in shaping future policies and recommendations targeting HAI prevention.

The New Mexico EIP HAIC is currently working on multiple projects, including but not limited to Multi-Site Gram-negative Surveillance Initiative, C.diff Infection Surveillance, Candida Bloodstream Infection Tracking, and Antibiotic Use Prevalence Surveys. New Mexico EIP HAIC is also involved in some shorter-term projects dedicated to determining the burden, risk factors, and prevention strategies for HAI.

Please visit the Emerging Infections Program Healthcare Associated Infections Community Interface website to learn more.

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Advisory Committee

The New Mexico HAI Advisory Committee was formed after the Hospital-acquired Infection Act (NMSA 1978 §§ 24-29) was passed to guide the development of the New Mexico HAI program including establishing surveillance standards, identifying the HAI indicators to be subject to surveillance and to develop useful, and understandable public reporting mechanisms.

Meetings

The committee complies with the open meetings act and any meetings subject to the open meetings act, at which the discussion or adoption of any proposed resolution, rule, regulation or formal action occurs, are open to the public.

Schedule

The committee meets every other month from 9:00am-11:00am. The meeting scheduled for 2018 is as follows.

  • Thursday, January 25, 2018 @ 9:00 AM - 11:00 AM — HealthInsight New Mexico Offices
  • Thursday, March 22, 2018 @ 9:00 AM - 11:00 AM — HealthInsight New Mexico Offices
  • Thursday, May 24, 2018 @ 9:00 AM - 11:00 AM — HealthInsight New Mexico Offices
  • Sunday, August 26, 2018 @ 9:00 AM - 11:00 AM — HealthInsight New Mexico Offices
  • Thursday, September 27, 2018 @ 9:00 AM - 11:00 AM — HealthInsight New Mexico Offices
  • Thursday, November 15, 2018 @ 9:00 AM - 11:00 AM — HealthInsight New Mexico Offices

Location

Unless otherwise indicated, all meetings are held at the HealthInsight New Mexico Offices located at 5801 Osuna NE (Suite 200) in Albuquerque.

Agendas

The agenda for regular meetings will be made available at least seventy-two hours before each meeting. A copy of the agenda may be requested by contacting us at our hai.program@doh.nm.gov address or calling 505-476-3520.

In addition to posting any changes in date, location or time on this site, a written notice of change will be posted at the HAI program offices at the Harold Runnels Building.

Membership

Committee member representation currently consists of the following. Additional members of the committee are chosen based on the current focus of the HAI work and expertise that can further that work.

Non-Voting Members

  • Advisory Committee Facilitator, New Mexico HAI Coordinator, NMDOH

Voting Members

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Health Data

Annual Reports

Plans

Memorials

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Training Materials

Personal Protective Equipment

Personal protective equipment (PPE) are specific clothing or equipment worn by employees for protection against infectious materials.  PPE can comprise of gloves, gowns, shoe covers, head covers, masks, respirators, eye protection, face shields, and goggles.

For more information about personal protective equipment, please visit:

Healthcare Worker Immunizations

Patient Safety and Healthcare Quality

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Learn More

  • Agency for Health Research and Quality — Our vision is that the Academy for Integrating Behavioral Health and Primary Care will function as both a coordinating center and a national resource for people committed to delivering comprehensive, integrated healthcare.
  • Association for Professionals in Infection Control and Epidemiology (APIC) — The Association for Professionals in Infection Control and Epidemiology is the leading professional association for infection preventionists (IPs) with more than 15,000 members. Our mission is to create a safer world through the prevention of infection. This is achieved by the provision of better care to promote better health at a lower cost. Most members are nurses, physicians, public health professionals, epidemiologists, microbiologists, or medical technologists.
  • Centers for Medicare and Medicaid Services — The Centers for Medicare & Medicaid Services website is a resource to help Americans with access to health care coverage, better care, and improved health.
  • Council of State and Territorial Epidemiologists — The Council of State and Territorial Epidemiologists works to advance public health policy and epidemiologic capacity. We also provide information, education, and developmental support of practicing epidemiologists in a wide range of areas as well as expertise for program and surveillance efforts. We are an organization of member states and territories representing public health epidemiologists. We also work to establish more effective relationships among state and other health agencies. We also provides technical advice and assistance to partner organizations and to federal public health agencies such as the Centers for Disease Control and Prevention.
  • Healthcare-Associated Infections Information — An infection whose development is favored by a hospital environment, such as one acquired by a patient during a hospital visit or one developing among hospital staff. Hospital-acquired infections are an important category of hospital-acquired conditions. HAI is sometimes expanded as healthcare-associated infection to emphasize that infections can be correlated with health care in various settings (not just hospitals), which is also true of hospital-acquired conditions generally.
  • Healthcare-Associated Infections Prevention Plans — Prevention plans for other states in the US.
  • Hospital Compare — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find hospitals and compare the quality of their care. The information on Hospital Compare helps you make decisions about where you get your health care and encourages hospitals to improve the quality of care they provide. In an emergency, you should go to the nearest hospital. When you can plan ahead, discuss the information you find here with your health care provider to decide which hospital will best meet your health care needs.
  • Institute for Healthcare Improvement — The Institute for Healthcare Improvement, an independent not-for-profit organization based in Cambridge, Massachusetts, is a leading innovator, convener, partner, and driver of results in health and health care improvement worldwide. At our core, we believe everyone should get the best care and health possible. This passionate belief fuels our mission to improve health and health care.
  • National Healthcare Safety Network (NHSN) — National Healthcare Safety Network is a secure surveillance system widely used in tracking healthcare-associated infection. NHSN provides facilities, states, regions, and the nation with data needed to identify problem areas, measure the progress of prevention efforts, and ultimately eliminate healthcare-associated infections.
  • One Health — The goal of One Health is to encourage the collaborative efforts of multiple disciplines working locally, nationally, and globally to achieve the best health for people, animals, and our environment.
  • Society for Healthcare Epidemiology of America — The Society for Healthcare Epidemiology of America is a professional society representing physicians and other healthcare professionals around the world with expertise and passion in healthcare epidemiology, infection prevention, and antimicrobial stewardship. The Society for Healthcare Epidemiology of America improves patient care and healthcare worker safety in all healthcare settings through the critical contributions of healthcare epidemiology and improved antibiotic use. The society leads this specialty by promoting science and research, advocating for effective policies, providing high-quality education and training, and developing appropriate guidelines and guidance in practice.
  • State-Based HAI Prevention — Resources for state-based prevention of HAIs.
  • The Joint Commission — Our mission is to continuously improve health care for the public, in collaboration with other stakeholders, by evaluating health care organizations and inspiring them to excel in providing safe and effective care of the highest quality and value.

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