Healthcare Associated Infections:Data Summary and Commonly Asked

Questions

Shannon Millay, MPHHealthcare Associated Infections Epidemiologist

October 12, 2012

Objectives

• HAI Reporting– Data from 1st and 2nd Quarter

• Commonly Asked Questions– Upcoming Changes– Available Resources– Contact Info

HAI Reporting: Data Summary

• Mandatory HAI Reporting– CAUTI– CLABSI– SSI (abdominal hysterectomy and colon surgery)

• 129/131 facilities enrolled and reporting– Acute Care, LTAC, Rehab, Critical Access– Must have an ICU and/or perform abdominal

hysterectomy or colon surgery

HAI Reporting: Data Summary

• ISDH- Monthly reporting deadlines– Data should be in by end of following month– We understand that is not always possible

• CMS deadlines are quarterly– Q1 was due August 15– Q2 is due November 15

Standard Infection Ratio (SIR)

• The SIR is a summary measure used to track HAIs– Adjusts for patients of varying risk within each facility– Combine data from multiple locations into one single number

that can be used for comparisons.• Can summarize data at any level: by unit, hospital, regional, state or

national

• SIR= observed # of infections predicted # infections

– Predicted number is based on national baseline data from 2006-2008.

– If SIR >1, more infections than predicted– If SIR < 1, fewer infections than predicted.

CAUTI

Year/Quarter CAUTI Count Catheter DaysNumber Expected SIR p-value

95% Confidence

Interval

2012 - Q1 103 59456 107.70 0.96 0.3478 0.781, 1.160

2012 - Q2 123 53311 96.46 1.28 0.0052 1.060, 1.521

• Q1, we had 103 CAUTIs. Based on national baseline data, we

were predicted to have 108. The SIR is .96, meaning Indiana saw 4% fewer infections than what would be predicted from the national data. The p-value is greater than .05, so this difference is not significant.

• Q2- we had 123 CAUTIs and were predicted to have 96. The SIR is 1.28, or 28% higher than what would be predicted from the national data. This difference is significant.

CLABSI

• Q1- We had 59 CLABSIs and were predicted to have 105. Our SIR is .56, or 44% below what would be predicted from national data. This difference is significant.

• Q2- We had 63 CLABSIs and were predicted to have 101. Our SIR is .62, or 38% below what would be predicted from the national data. This difference is significant.

Year/Quarter CLABSI CountCentral Line

DaysNumber Expected SIR p-value

95% Confidence

Interval

2012 - Q1 59 54978 105.32 0.56 0.0000 0.426, 0.723

2012 - Q2 63 52068 100.83 0.62 0.0000 0.480, 0.799

SSI: Colon Surgery

• Q1- Indiana had 122 SSI from colon surgeries. We were predicted to have 111. The SIR is 1.10, meaning we saw 10% more infections that we were predicted to have. This difference is not significant.

• Q2- Indiana had 75 SSI from colon surgeries. We were predicted to have 81. The SIR is .92, meaning we saw 8% fewer infections that we were predicted to have. This difference is not significant.

Year/Quarter SSI (Colon)Central Line

DaysNumber Expected SIR p-value

95% Confidence

Interval

2012 - Q1 122 1799 111.03 1.10 0.16 0.909, 1.316

2012 - Q2 75 1368 81.14 0.92 0.2692 0.723, 1.164

SSI: Abdominal Hysterectomy

• Q1- Indiana had 27 SSI from abdominal hysterectomies. We were predicted to have 31. The SIR is 0.87, meaning we saw 13% fewer infections than we were predicted to have. This difference is not significant.

• Q2- Indiana had 23 SSI from abdominal hysterectomies. We were predicted to have 28. The SIR is 0.82, meaning we saw 18% fewer infections than we were predicted to have. This difference is not significant.

Year/Quarter SSI (Hyst)Central Line

DaysNumber Expected SIR p-value

95% Confidence

Interval

2012 - Q1 27 1584 31.05 0.87 0.268 0.568, 1.274

2012 - Q2 23 1466 28.09 0.82 0.1953 0.514, 1.238

Commonly Asked Questions

• I sent a waiver in to CMS…do I still need to report to ISDH?– Yes. CMS waivers do not apply to ISDH reporting.– We require reporting on all of the required HAIs, regardless

of the number of infections seen or number of procedures performed.

• Is ISDH making any changes to its reporting requirements?– At this point, ISDH is not making any changes to reporting

for 2013. – Will keep IPs informed of any revisions for 2014.

Commonly Asked Questions

• Now that the LTC component has been added in NHSN, do I need to re-accept the template of rights?– No. You will receive a notification in NHSN if ISDH changes

its template of rights.

• Is there any new NHSN training available?– NHSN 3-day web training “Protocol, Analysis, and

Reporting: Getting the Most from NHSN”• http://www.cdc.gov/nhsn/Training/live-web-training.html

– NHSN training for LTC component• http://www.cdc.gov/nhsn/Training/LTC/index.html

Announcements

• I recently got married and will be changing my name

– Shannon Millay Shannon Arroyo

• I will send my updated email/contact information when it becomes available.– Until then, I can be reached at smillay@isdh.in.gov or

(317) 233-7036

Thank you!

Questions?