The Florida Legislature has established Hospital Acquired Infections (HAI's) as a serious Patient Safety Issue and Florida Statute 395.1012 requires all hospitals to provide patients with data on the rate of Hospital Acquired Infections. In response to the passage of public policy that established this requirement, our society has published information for our members that compares our state with other states of similar size and structure, data on the current economic impact of HAI's and resources that our members and other stakeholders can use to help prevent the transmission of HAI's at the facility level.

HealtH Aquired Infections - Comparison Between States

The chart below compares the number of cases for each type of HAI among the four most populous states—California, Texas, Florida, and New York—in 2023, based on data from Definitive Healthcare.

Summary of Findings From Current Research

• California consistently reported the highest number of HAIs across all categories, likely due to its large population and hospital volume.
• Florida ranked fourth in total HAIs (4,503), trailing behind California (8,024), New York (5,491), and Texas (5,177).
• For CAUTIs, Florida reported 549 cases, significantly lower than California’s 1,368 and New York’s 940.
• In SSI-Hysterectomy cases, Texas led with 203 cases, while Florida followed closely with 168 cases.
• Florida reported 496 cases of SSI-Colon infections, slightly lower than Texas (588) and California (706).
• C. Diff cases in Florida (1,980) were lower than those in California (3,849) and New York (2,467).
• Florida had 643 MRSA cases—second only to California (658).
• CLABSI cases in Florida totaled 667, third behind California (1,299) and Texas (929).

Economic Impact of Health acquired infections

HAIs significantly impact the cost of healthcare by increasing labor expenses and extending patient length of stay (LOS). Recent findings indicate that patients with HAI incur considerably higher costs and prolonged hospitalizations compared to their HAI-negative counterparts. For example:

• CLABSI: Excess labor cost per admission is approximately $43,975 with 13.4 additional hospital days.
• CAUTI: Excess labor cost per admission is approximately $31,253 with an 8.9-day increase in LOS.
• SSI: Excess labor cost per admission is approximately $5,985 with 1.4 extra hospital days.

Over a four-year period, the additional cost amounted to $23.4 million and 4,810 extra hospital days. Notably, 100% of the CLABSI and CAUTI cases occurred after the 13th day of hospitalization, suggesting that minimizing pre-infection LOS could have a greater economic and safety impact than focusing solely on infection prevention. For SSIs, which typically occur early during admission, prevention strategies remain critical, especially given an 83% re-admission rate for SSI patients (Open Forum Infectious Diseases, 2022).

Also in response to the efforts of the Florida Legislature to deal with HAIs our society has published some recommendations and resources to help our members improve the infection control and prevention at the facility level. 

Infection Prevention Challenges &

Evolving Strategies

A 2022 article in the American Journal of Infection Control highlights critical challenges facing infection prevention programs and offers innovative, evidence-based strategies for improvement. The key challenges and recommendations include:

1. IP Program Standardization

• Challenge: Variability in how infection preventionists (IPs) allocate their time and differences in staffing levels across facilities.
• Recommendation: Establish a standardized process design using established competency models to replicate best practices and reduce errors (American Journal of Infection Control, 2022).

2. Surveillance

• Challenge: Manual surveillance is labor-intensive and error-prone, consuming up to 45% of IP time.
• Recommendation: Implement automated surveillance systems integrated with EHRs to enhance efficiency and accuracy (American Journal of Infection Control, 2022).

3. Hand Hygiene

• Challenge: Consistent hand hygiene compliance is difficult due to placement of supplies, observer bias, and inconsistent data collection.
• Recommendation: Use multimodal strategies, including leadership support, education, and both direct and automated monitoring, to improve compliance (American Journal of Infection Control, 2022).

4. Environmental Contamination

• Challenge: The patient environment is a major source of pathogen transmission; manual cleaning often leaves many surfaces inadequately disinfected.
• Recommendation: Adopt automated disinfection technologies (e.g., UV-C, hydrogen peroxide, electrostatic sprayers) to ensure thorough cleaning (American Journal of Infection Control, 2022).

5. Antibiotic-Resistant Organisms (AROs)

• Challenge: AROs contribute to nearly 5 million deaths globally and complicate treatment due to limited effective antibiotics.
• Recommendation: Enhance diagnostic capabilities, rapid diagnostic testing, and reinforce antibiotic stewardship programs (American Journal of Infection Control, 2022).

6. Decolonization Strategies

• Challenge: Pathogen colonization increases the risk of HAIs.
• Recommendation: Utilize evidence-based decolonization protocols, such as CHG bathing and nasal decolonization with mupirocin, to reduce infection rates (American Journal of Infection Control, 2022).

7. Decreasing Contact Precautions

• Challenge: Overly stringent contact precautions may lead to patient dissatisfaction and other adverse outcomes.
• Recommendation: Reevaluate and modify contact precaution policies based on organism-specific risks and facility resources (American Journal of Infection Control, 2022).