NGC - Resources - Hospital Acquired Conditions

Preventing Hospital-Acquired Conditions (HACs)

Section 5001(c) of the Deficit Reduction Act of 2005 requires the Secretary of Health and Human Services to identify conditions that are: (a) high cost or high volume or both, (b) result in the assignment of a case to a diagnosis related group (DRG) that has a higher payment when present as a secondary diagnosis, and (c) could reasonably have been prevented through the application of evidence-based guidelines.

If at discharge, there is a selected condition that was either not identified by the hospital as present on admission, or could not be identified based on data and clinical judgment at admission, it is considered hospital-acquired. To encourage hospitals to avoid hospital-acquired conditions, beginning October 1, 2008, Medicare no longer pays hospitals at a higher rate for the increased costs of care that result when a patient is harmed by one of the listed conditions if it was hospital-acquired. Medicare prohibits the hospital from billing the beneficiary for the difference between the lower and higher payment rates. The inpatient prospective payment system fiscal year (IPPSFY) 2009 Final Rule is available from the Centers for Medicare and Medicaid Services (CMS) Web site.

Listed below by condition are evidence-based guideline resources available on NGC to assist users in the prevention of the CMS-identified hospital-acquired conditions.

Foreign Object Retained After Surgery
- Prevention of unintentionally retained foreign objects during vaginal deliveries. Health care protocol (Not yet published to NGC)

Air Embolism
- Access device guidelines: recommendations for nursing practice and education

Blood Incompatibility

There are no guideline resources available on this condition at this time.

Stage III and IV Pressure Ulcers
Guideline Synthesis: Pressure Ulcer Prevention

Falls and Trauma including fractures, dislocations, intracranial injuries, crushing injuries, burns, and electric shock
Falls
- Changing the practice of physical restraint use in acute care
- Fall management guideline (Update in progress)
- Fall prevention for older adults
- Preventing falls in acute care. In: Evidence-based geriatric nursing protocols for best practice
- Prevention of falls (acute care). Health care protocol (Not yet published to NGC)
- Prevention of falls and fall injuries in the older adult
Trauma
- Practice advisory for the prevention and management of operating room fires
- Reducing adverse drug events. In: Evidence-based geriatric nursing protocols for best practice
Guideline Synthesis: Fall Prevention in the Elderly

Manifestations of Poor Glycemic Control

Catheter-Associated Urinary Tract Infection (UTI)

Vascular Catheter-Associated Infection

Surgical Site Infection
General
- Prevention of surgical site infections. In: Prevention and control of healthcare-associated infections in Massachusetts
- Strategies to prevent surgical site infections in acute care hospitals
Following Coronary Artery Bypass Graft (CABG) - Mediastinitis
- ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery)
- Antibiotic prophylaxis in surgery. A national clinical guideline
Following Bariatric Surgery
- Antibiotic prophylaxis in surgery. A national clinical guideline
Following Orthopedic Procedures Specific to Spine, Neck, Shoulder, and Elbow
- Antibiotic prophylaxis in spine surgery
- Antibiotic prophylaxis in surgery. A national clinical guideline

Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE) following total knee replacement and hip replacement

Preventing Hospital-Acquired Conditions (HACs)

Search

Resources

Browse

Compare