Alabama Hospitals Show Improvement in Healthcare-Associated Infection Rates

Alabama hospitals demonstrated better-than-expected performance in healthcare-associated infection (HAI) rates in 2024, according to a recent report released by the Alabama Department of Public Health (ADPH). The annual report, which utilizes data from acute and critical access care facilities across the state, revealed improvements in three out of four measured infection types.

Understanding Healthcare-Associated Infections

Healthcare-associated infections (HAIs) are infections patients acquire during treatment for other conditions within a healthcare setting. According to the U.S. Centers for Disease Control and Prevention (CDC), approximately 1 in 31 hospital patients contract an HAI [1]. These infections are a significant concern, ranking among the top 10 causes of death in the United States.

Key Findings from the 2024 Report

The ADPH report focused on four specific infection types: catheter-associated urinary tract infections (CAUTI), central line-associated bloodstream infections (CLABSI), and surgical site infections (SSI) related to colon surgeries and abdominal hysterectomies.

• Catheter-Associated Urinary Tract Infections (CAUTI): Alabama maintained lower-than-predicted CAUTI rates for the 14th consecutive year, with a standardized infection ratio (SIR) of 0.50.
• Central Line-Associated Bloodstream Infections (CLABSI): The SIR for CLABSIs decreased from 0.84 in 2023 to 0.70 in 2024.
• Colon Surgical Site Infections: Alabama hospitals showed improvement, with the SIR increasing from 0.73 in 2023 to 0.75 in 2024, and performing better than the national baseline for the 14th year.
• Abdominal Hysterectomy Surgical Site Infections: Performance was similar to the national baseline, with an SIR decreasing from 0.97 in 2023 to 0.84 in 2024.

Importance of Reporting and Prevention

Melanie Roderick, epidemiologist supervisor at ADPH, emphasized the value of the report for patients. “If somebody knows that they are going to have a colon surgery coming up, they can pull up the report and look at the hospitals in their area and ensure that the hospital that they are going to to have the surgery,” Roderick said. “Look at their ranking, as opposed to performing better or similar or worse to the national baseline.”

The ADPH HAI Reporting and Prevention Program aims to establish a standardized method for collecting, reporting, and evaluating HAI data across healthcare facilities in Alabama [1]. This data is reported through the CDC’s National Healthcare Safety Network (NHSN).

Hospitals Addressing Infection Control

While most hospitals demonstrated improvement, three facilities experienced HAI rates higher than the national baseline:

• DCH Regional Medical Center (Tuscaloosa): Five abdominal hysterectomy surgical site infections out of 266 procedures.
• Thomas Hospital (Fairhope): Six colon surgical site infections out of 130 procedures.
• Jackson Hospital and Clinic: Nine central line-associated bloodstream infections out of 3,579 procedures.

Jackson Hospital and Clinic identified deficiencies in its maintenance kits and implemented changes to care protocols and staff training, resulting in improved outcomes. The ADPH provides opportunities for hospitals performing below the national baseline to offer statements explaining their performance.

Looking Ahead

Alabama State Health Officer Dr. Scott Harris expressed satisfaction with the overall performance of Alabama hospitals. The 2025 report is currently being compiled, with previous reports having been delayed due to the pandemic. Continued focus on staff training and adherence to established protocols remains crucial for further reducing HAI rates in the state.