National Healthcare Safety Network: Future Directions

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National HealthcareSafety NetworkFuture
Directions

• Mary Andrus, BA, RN, CIC
• Surveillance Branch, Division of Healthcare
  Quality Promotion
• NCPDCID/CCID/CDC
• Acknowledgment
• Slides provided by Dan Pollock, M.D.
• Surveillance Branch Chief

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Healthcare Facilities Enrolled in NHSNDoubling
in 2007 and 2008
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NHSN Componentsand Modules
NHSN
Component Research and Development
Component Heathcare Personnel Safety
Component Patient Safety

• Events Modules
• Device Associated
• Procedure Assoc.
• Medication Assoc.
• MDRO and CDAD
• High Risk Inpatient
• Influenza Vaccination

• eSurveillance
• HL7 Messages
• HL7 CDA
• Prevention research

Modules Blood/Body Fluid Exposure
Vaccination
HL7 Health Level Seven CDA Clinical Document
Architecture
MDRO Multidrug-resistant
organism CDAD Clostridium difficile
associated disease
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NHSN Componentsand Modules
NHSN
Component Patient Safety

• Device-Associated Events
• CLABSI Central line-associated
• bloodstream infection
• VAP Ventilator-associated pneumonia
• CAUTI Catheter-associated urinary
• tract infection
• DI Dialysis incident
• CLIP Central Line Insertion Practices

• Events Modules
• Device Associated
• Procedure Assoc.
• Medication Assoc.
• MDRO and CDAD
• High Risk Inpatient
• Influenza Vaccination

New option in 2008
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NHSN Componentsand Modules
NHSN
Component Patient Safety

• Procedure-Associated Events
• SSI Surgical site infection
• PPP Post-procedure pneumonia

• Events Modules
• Device Associated
• Procedure Assoc.
• Medication Assoc.
• MDRO and CDAD
• High Risk Inpatient
• Influenza Vaccination

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NHSN Componentsand Modules
NHSN
Component Patient Safety
Antimicrobial Use and Resistance Microbiology
susceptibility test results and/or Antimicrobial
use for A minimum of 6 months per calendar year
in specified hospital areas (e.g., Intensive Care
Unit, Specialty Care Area).

• Events Modules
• Device Associated
• Procedure Assoc.
• Medication Assoc.
• MDRO and CDAD
• High Risk Inpatient
• Influenza Vaccination

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NHSN Componentsand Modules
NHSN
New Module and Options in 2008
Component Patient Safety

• Multi-drug Resistant Organsim or Clostridium
  difficile-Associated Disease
• Two options MDRO or CDAD
• Outcome measures
• - MDRO or CDAD infection surveillance
• - Laboratory-identified events
• - Prevalence and incidence based on active
• surveillance testing (AST)
• Process measures monitoring adherence to
• - AST, when in use
• - After-contact hand hygiene
• - Gown and glove use as part of contact
  precautions

• Events Modules
• Device Associated
• Procedure Assoc.
• Medication Assoc.
• MDRO and CDAD
• High Risk Inpatient
• Influenza Vaccination

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NHSN Componentsand Modules
NHSN
New Module and Options in 2008
Component Patient Safety

• Influenza Vaccination Coverage
• Method A Summary-level data collection.
• Recommended for retrospective review of
  inpatient
• medical records
• Method B Patient-level data collection.
• Recommended for prospective tracking of
  inpatient
• admissions

• Events Modules
• Device Associated
• Procedure Assoc.
• Medication Assoc.
• MDRO and CDAD
• High Risk Inpatient
• Influenza Vaccination

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NHSN Componentsand Modules
NHSN
Component Heathcare Personnel Safety
Component Research and Development
Works in Progress

• eSurveillance
• HL7 Messages
• HL7 CDA
• Prevention research

Modules Blood/Body Fluid Exposure
Vaccination
HL7 Health Level Seven CDA Clinical Document
Architecture
New Modules in 2008
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NHSN Antimicrobial Use and Resistance (AUR) Data
Healthcare Facility
CDC
Web-based data entry and data access
Rules for Security, Primary Data Entry, and
Supplemental Data Entry
NHSN Application
Facility Firewall
CDC Firewall
Standard HL7 Messages
Parsing Coding Validating
Interface Engine/ Data Repository
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NHSN Healthcare Associated Infection (HAI) Data
Healthcare Facility
CDC
Entry of location mapping codes and monthly
reporting plan
Web-based data entry and access
NHSN Application
Facility Firewall
CDC Firewall
Vendor system collects HAI data and creates CDA
document
CDA Document (HAI event record)
Parsing and Validating
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NHSN Priorities and Plans

• Add infrastructural capacity and ramp up user
  training and support as enrollment increases
• Capitalize on advances in infection control,
  hospital epidemiology, informatics, and
  information technology
• Update and add definitions, protocols, methods,
  and modules as warranted
• Address challenges of mandatory public reporting
  and the possibility of a new federal role
• Publish and provide data that meet the needs of
  the public, practitioners, researchers, and
  policymakers

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Thank You!
www.cdc.gov/ncidod/dhqp/nhsn.html