1. Healthcare Associated Infections: Data Summary and Commonly Asked Questions Shannon Millay, MPH Healthcare Associated Infections Epidemiologist October 12, 2012

2. Objectives HAI Reporting – Data from 1 st and 2 nd Quarter Commonly Asked Questions – Upcoming Changes – Available Resources – Contact Info

3. 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

4. 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

5. 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.

6. CAUTI Year/QuarterCAUTI CountCatheter Days Number ExpectedSIRp-value 95% Confidence Interval 2012 - Q110359456107.700.960.34780.781, 1.160 2012 - Q21235331196.461.280.00521.060, 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.

7. 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/QuarterCLABSI Count Central Line Days Number ExpectedSIRp-value 95% Confidence Interval 2012 - Q15954978105.320.560.00000.426, 0.723 2012 - Q26352068100.830.620.00000.480, 0.799

8. 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/QuarterSSI (Colon) Central Line Days Number ExpectedSIRp-value 95% Confidence Interval 2012 - Q11221799111.031.100.160.909, 1.316 2012 - Q275136881.140.920.26920.723, 1.164

9. 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/QuarterSSI (Hyst) Central Line Days Number ExpectedSIRp-value 95% Confidence Interval 2012 - Q127158431.050.870.2680.568, 1.274 2012 - Q223146628.090.820.19530.514, 1.238

10. 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.

11. 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

12. 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) 233-7036smillay@isdh.in.gov

13. Thank you! Questions?