For VAP, the percentages of ICUs that had policies as well as adherence to those practices were lower. While 74% of ICUs had a ventilator bundle checklist, only 52% of those treating patients were seen to adhere to that checklist.
For the policy of raising the head of a patient's bed 45 degrees, 91% had such a policy, but only 49% of caregivers adhered to it.
And for CAUTI prevention, 27% of ICUs had a policy for a nurse-assisted catheter insertion, but only 22% were seen to observe that practice.
The report also found that on average, the number of infection preventionists per 100 ICU beds was 1.2, which is higher than the current guideline of 1 per 250 beds, developed in 1985, and a survey a decade ago which recommended .8 per 100 beds.
Stone says, however, that the ratio is not optimal because the guidelines are out of date, because the cost of HAIs has risen, and because proven strategies can reduce infections when clinicians adhere to them.
Another finding from the study was that the number of infection preventionists and hospital epidemiologists who have appropriate certification "varied across institutions."