The Impact of the Covid-19 Pandemic on Device-Associated Healthcare-Associated Infections in Nevada

Healthcare-associated infections or hospital-acquired infections (HAIs) have remained prevalent despite the growth of infection control programs in healthcare facilities and are a large cause of morbidity and mortality. Device-associated HAIs (DA-HAIs) make up a large portion of HAIs. The devices include central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and ventilator-associated events (VAEs). DA-HAIs became a large concern during the COVID-19 pandemic as many healthcare facilities became overwhelmed by the influx of COVID-19 cases, illuminating the importance of studies to examine these changes. Therefore, this study aimed to evaluate how DA-HAI rates have changed during and after the COVID-19 pandemic in Nevada and how device utilization has influenced this change. This study utilized a cross-sectional analysis design, including data from the National Healthcare Safety Network (NHSN) on CLABSIs, CAUTIs, and VAEs from January 1, 2018, to March 31, 2024, in Nevada. The study has three defined periods: pre-pandemic/baseline (2018-2019), the pandemic period (2020-2022), and post-pandemic (2023-2024). Results indicated that VAEs significantly increased during the pandemic period and have remained high in the post-pandemic period. There was no change in CAUTIs throughout the three periods. A period change was observed in CLABSIs, but only in acute care hospitals. Device utilization was a significant predictor for VAEs and in some healthcare settings for CLABSIs. Differences were also noted in bed size and geographical location in Nevada for some healthcare settings. Understanding the effect of the COVID-19 pandemic can help improve and sustain infection control programs to respond to future pandemics.