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Learning Objective 1: The learner will be able to understand the systematic design and development of a tool that characterizes state focus on HAI in nursing homes (NH).
Learning Objective 2: The learner will recognize state Department of Health (DOH) activities that constitute focus on HAI reduction in NH and how these differ across states
Methods: Content validity was assured through input from leading experts in the field who identified general elements that characterize state focus on HAI in NH. Elements were refined through iterative examination of the types and breadth of infection prevention activities in NH implemented by 20 state DOH, as described on the internet. Websites of the Centers for Disease Control and Prevention (CDC), the Association for Professionals in Infection Control and Epidemiology (APIC), Medicare and others linked to the DOH sites were examined to determine that all relevant data were captured. A protocol for data collection and operational definitions of relevant terms was developed. Two independent raters piloted the tool in two states to establish reliability. Where there was disagreement, definitions and interpretations of tool items were discussed with a third independent reviewer.
Results: The tool contains 16 items regarding state focus on HAI prevention in NH. State DOH activities include 1) publicizing information directed at consumers intended to increase accountability of and competition between NH, including HAI reporting, and NH inspection reports 2) offering surveyor training for NH inspections and 3) providing information for NH providers to prevent HAI and monitor progress in HAI reduction. The presence of activities within these categories is recorded as “yes”, “no information available on website” or “other” to allow quantitative analysis as well as qualitative descriptions of the activity and webpages.
Conclusions: This data collection tool allows comparison of activities through consistent data collection and ensures meaningful characterization of state focus on HAI reduction in NH.