5 Conclusions

This 14th annual report and the sixth report using online format shows some significant differences from the 2020 report. The 2021 CAUTI SIR, 0.9 (95% CI: (0.86, 0.95)), was statistically significantly more (p-value = 0.01) than the 2020 SIR, 0.82 (95% CI: (0.78, 0.87)). The 2021 CDI LabID SIR value (SIR: 0.57; 95% CI: (0.55, 0.59)) was statistically significantly lower (p-value = 0.01) than in 2020 (SIR: 0.61 (95% CI: (0.59, 0.64))) and was below the 2030 HHS goal of 0.70. The 2021 SIR from CBG surgery with one incision (SIR: 0.37; 95% CI: (0.09, 1.00)) was statistically significantly lower (p-value = 0.03) than in 2020 (SIR: 1.43 (95% CI: (0.70, 2.63))). Neither was different from the 2015 national baseline though.

The 2021 SIR values from the following HAIs were higher than the 2020 SIR values but did not reach statistical significance: CLABSI, MRSA bloodstream infection, HYST SSI, CARD SSI, and COLO SSI SIR values.The 2021 CLABSI SIR increased from 0.84 (95% CI: (0.79, 0.88)) in 2020 to 0.9 (95% CI: (0.85, 0.94)). The 2021 MRSA SIR value of 0.92 (95% CI: (0.84, 1.00)) also increased since 2020 (0.87 (95% CI: (0.79, 0.96)). The HYST SSI SIR increased from 0.7 (95% CI: (0.53, 0.91)) in 2020 to 0.81 in 2021 (95% CI: (0.62, 1.03)). The CARD SSI SIR increased from 0.86 (95% CI: (0.58, 1.23)) in 2020 to 1.26 in 2021 (95% CI: (0.93, 1.68)). The COLO SSI SIR increased slightly from 0.8 (95% CI: (0.72, 0.90)) in 2020 to 0.84 in 2021 (95% CI: (0.76, 0.93)).

Hospitals reported six fewer KPRO SSIs than in 2020 and the 2021 SIR (SIR: 0.81; 95% CI: (0.67, 0.98)) was lower than in 2020 (SIR: 0.91; 95% CI: (0.75, 1.09)).

This report also shows that some 2021 SIR values were the same as those from the 2015 national baseline and have not changed since 2020. The SIR from CBGB remained close to 1.0 in 2021 as it did in 2020. The number of HPRO SSIs was not different than predicted (SIR: 1.08; 95% CI: (0.94, 1.24)) and was nearly identical to that in 2020 (SIR: 0.98; 95% CI: (0.84, 1.14)).

Both Pennsylvania and CDC envision a future in which patients do not acquire HAIs during their hospital stays. To achieve this goal hospitals should continue their efforts to reduce HAIs by implementing evidence-based guidelines and multifaceted infection prevention interventions. Patients and families should proactively ask questions to health care staff about ways to prevent infections during hospitalizations, including asking providers to perform hand hygiene before providing care and touching patients and items in their room. Hospitals can continue their efforts to follow evidence-based guidelines, such as removal of catheters when no longer medically necessary, implementation of antibiotic stewardship programs, education for patients to care for themselves after leaving the hospital, and education for staff and patients about ways to prevent HAIs.

This report used the same statistical methods and reference population as Pennsylvanian HAI reports beginning in 2016. HAI statistics from this report can be compared with data from those reports when the same level of aggregation is used (e.g., state level, hospital type level, or hospital level). These data can also be compared with SIR values published by CDC that use the 2015 national baseline as the reference group.

Pennsylvania hospitals are encouraged to use available free consultative resources from PSA, Quality Insights, and Hospital and Health System Association of Pennsylvania to implement evidence-based practices to reduce HAIs.

It is important to note that the Department works collaboratively with a variety of stakeholder organizations to promote health care quality and reduce the incidence of HAIs. In addition, two governmental partners, the PSA and the PHC4, have specific roles under Act 52 and work closely with the Department on HAI prevention and control. Readers of this annual report are encouraged to examine companion reports published by PSA and PHC4. The PSA annual report for 2021⁵⁰ describes serious events, incidents and deaths in the acute care setting. The PHC4 report titled, “The Impact of Healthcare-Associated Infections in Pennsylvania, 2010,” examines costs, mortality, readmissions, and underlying health conditions associated with HAIs. PHC4 also published reports in 2019 and 2020 which evaluated mortality among children and adults, respectively, who had cardiac surgery. They also authored a 2021 and 2023 report regarding complication rates following knee replacement, hip replacement, and CBG surgery (Common Procedures report) that occurred between 2020 and 2021 and 2021 and 2022, respectively. These can be found at http://www.phc4.org.