Robin Nettleton MSN RN St. Luke’s Elmore, Mountain Home APIC 43rd Annual Conference Charlotte, NC June 11-13 Incorporating CDC’s NHSN into Nursing Home Infection Surveillance Programs Robin Nettleton MSN RN St. Luke’s Elmore, Mountain Home

If you wanted to compare your infection surveillance data to another nursing home in Idaho that cared for a similar resident population, how confident are you that events were tracked the same way?

Impact of Using NHSN in Long Term Care Standardizes and validates surveillance definitions Allows for fair comparison of rates by facility characteristics and/or resident characteristics Provides national rates for facilities to use as a benchmark for assessing own rates and prevention efforts Trending over time will demonstrate trends in improvements

Facilities eligible for NHSN LTCF Enrollment Certified skilled nursing facilities and nursing homes Intermediate/chronic care facilities for developmentally disabled Assisted living facilities and residential care facilities (Currently limited to Prevention Process Measures 309 Facilities have enrolled since launch Sept. 2012

Nursing homes/Skilled nursing facility's located within a hospital that have a CCN number that is different from the hospital must be enrolled as a separate NHSN Facility within the LTCF Component.

NHSN Long Term Care facility Component Healthcare associated Infections (HAI) Laboratory-Identified (LabID) Event Prevention Process Measures UTI Catheter and non-cath associated Multi-drug Resistant Organisms Hand Hygiene Clostridium difficile Infection Gown Gloves

Urinary Tract Infection Two Types of UTI Symptomatic UTI (SUTI) Asymptomatic Bacteremic UTI (ABUTI) For Both Types- surveillance must occur for both catheter and non-catheter associated UTI events.

Key Points for UTI LTCF UTI doe not have a set time period during which only one UTI may be reported for the same resident Clinical info must be used to determine that the original infection had resolved before reporting a second New onset of signs and symptoms Completion of antimicrobial therapy If signs/symptoms resolved prior to onset of new signs/symptoms with a new urine culture a second UTI must be considered. Mixed flora is not an organism and cannot be reported Yeast cannot be reported as an organism, must have at least 1 qualifying bacterium All symptoms must be new or acutely worse.

Other Metrics LabID Events Prevention Process Measures Facility wide C.diff and MDRO Can chose to monitor one or more MDRO Prevention Process Measures Facility wide Hand Hygiene and Glove and Gown use Can chose one or both Minimally 30 observations per month

Questions?

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