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State HAI report: hospitals record fewer infections than predicted, program cites quality work and funding shifts
Summary
DHHS reported that New Hampshire hospitals and other facility types observed fewer healthcare-associated infections than predicted in 2023, but noted staffing and funding changes, areas for monitoring and plans to make reports more accessible.
Katrina Hanson, administrator in the Division of Public Health Services, presented the department's annual healthcare-associated infections (HAI) reports to the oversight committee and summarized 2023 findings, program activity and finances required by statute.
The nut graf: The department said overall infection counts were lower than predicted by national benchmarks in 2023, while noting some concerning specific trends and funding uncertainties that could affect program operations.
Hanson said hospitals reported fewer infections than predicted and that the state observed "statistically significant" reductions across main HAI categories. The department reported "only 135 were reported for the state" for an aggregate measure and 24 hospitals reported 174 C. difficile infections. Healthcare personnel influenza vaccination rates varied by setting: hospitals 89.9%, ambulatory surgery centers 80.1%, dialysis centers 52.6%, and long-term care facilities 50.1%.
She cited other findings: ambulatory surgery centers reported a small number of surgical-site infections and high adherence to antibiotic prophylaxis (>96%); dialysis centers reported fewer total infections year-over-year (299 in 2023 vs. 379 in 2022) but had higher-than-national rates of local vascular access site infections; the HAI program conducted more than 100 investigations in 2022–2023, including outbreak responses and drug-diversion inquiries; and 20 infection-prevention assessments were completed.
Hanson described program costs and funding. The HAI program's state fiscal year budget for producing reports was $348,203; the program also received a $328,817 Epidemiology Laboratory Capacity grant that was later reduced by about 40% in the following fiscal year. Because of received federal funds, the department reported it did not assess facility fees in 2023; when fees were assessed in prior years they ranged from $22,000 to $150,000 depending on facility size and procedures.
Committee members asked whether the observed declines are attributable to intentional interventions. Hanson said many partners contribute to infection reduction and that the program plays a role particularly for antibiotic-resistant organisms. She described how the program works with facilities to identify exposed patients and facilitate screening with a regional laboratory when resistant organisms are found. Committee members also asked about the delay in reporting (2023 calendar-year data released mid-2024) and why influenza vaccination rates are lower in dialysis and long-term care staff; Hanson said annual reconciliation, staffing transitions and outbreak response work explain approximately six months of delay and that reporting completeness may affect observed vaccination rates.
Ending: Hanson said the department plans to make data more accessible through interactive online tools, continue outbreak response and expand infection-prevention training to more geographic areas and facility types.
