Associations of State Legal Mandates
A collaborative study including Dr. Julie Reagan, examines the association of state legal mandates for data submission of central line-associated bloodstream infections in neonatal intensive care units with process and outcome measures. The study was conducted to determine the association between state legal mandates for data submission of central line-associated bloodstream infections (CLABSIs) in neonatal intensive care units (NICUs) with process and outcome measures. State mandates for data submission of CLABSIs in NICUs in place by 2011 were compiled and verified with state healthcare-associated infection coordinators. A web-based survey of infection control departments in October 2011 assessed CLABSI prevention practices, ie, compliance with checklist/bundle components (process measures) in ICUs including NICUs. Corresponding 2011 NHSN NICU CLABSI rates (outcome measures) were used to calculate standardized infection ratios (SIRs). Association between mandates and process and outcome measures was assessed by multivariable logistic regression. The study concluded that state mandates for NICU CLABSI data submission were significantly associated with ≥95% compliance with CLABSI prevention practices, which declined with the duration of mandate but not with lower CLABSI rates.