leagues (2010a) found that in 2008, 15- to 19-year-old women in the United States gave birth to 435,000 infants. A study by Chandra and colleagues (2005) found that unintended births accounted for almost two-thirds of the births to women younger than age 18, while for 18- to 19-year-old women, more than half of the births were unintended (Chandra et al., 2005). Total births per 1,000 women ages 15 to 19 years in the United States were 54.4, more than twice that of Great Britain (28.3) and Canada (24.5), five times that of France (10), and seven times the rate of Sweden (7.8) (Darroch et al., 2001). In the United States in 2006, the birth rate for white women aged 15 to 19 years was 38.2, for black women it was 64.6, and for Hispanic women it was 83.0 (Guttmacher Institute, 2010).

According to Hamilton and colleagues (2009), between 2005 and 2006 the overall teenage birth rate increased 4 percent, and between 2006 and 2007 the rate increased another 1 percent. In 2008, however, the teenage birth rate decreased by about 2 percent to 41.5 per 1,000 and preliminary data for 2009 indicate the rate may have decreased to 39.1 (Hamilton et al., 2010b). Despite this decrease, the immediate and long-term costs of adolescent pregnancies are great, with more than $9 billion U.S. tax dollars spent per year for “health care and foster care, increased incarceration rates among children of teen parents, and lost tax revenue because of lower educational attainment and income among teen mothers” (CDC, 2010k). Furthermore, while high school graduation rates are at almost 90 percent for women who did not give birth in adolescence, teen mothers are much more likely to drop out of high school; only about 50 percent have received a high school diploma by the time they are 22 years of age (Perper et al., 2010). Furthermore, the children of adolescent mothers fare worse than those of older women. Klitsch (2003) reported that “infants born to women aged 15 or younger had a substantially higher postneonatal mortality rate (3.2 per 1,000) than those born to 23- to 29-year-olds (0.8 per 1,000).

Adolescent pregnancy carries with it significant costs, for the mother, the child, and for society.

HA 1: Reduce Central Line-Associated Bloodstream Infections (CLABSI)

Central line-associated bloodstream infections (CLABSI) are the third most common health-care associated infection in the United States (CDC, 2005). Between 200,000 and 250,000 CLABSIs occur each year in U.S. hospitals (Doshi et al., 2009; O’Grady et al., 2002). CLABSIs have been associated with prolonged hospitalizations and complications with treating infections as well as an in-hospital mortality rate of 12 to 35 percent. There are between 500 and 4,000 deaths annually due to CLABSIs (Doshi et al., 2009). Because bloodstream infections are serious, they typically



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