Welcome to the National Healthcare Safety
Network, or NHSN, Hot Topic Session.
This presentation is a review of a new Device-
associated denominator sampling protocol for 2015.
Beginning in January 2015, hospitals can begin
to use an alternative method for collecting
denominator data for CLABSI and CAUTI
for eligible intensive care unit, or ICU,
and Ward location types. This new alternative
method reduces staff time that is spent on the
manual collection of CLABSI and CAUTI
denominator data. The new method requires the
collection on the number of patient days, and
central line and/or urinary catheter days one
day every week, for example, every Tuesday.
While device day data can be sampled in this
manner, hospitals using this method are still
required to collect and report the total number
of patient days for every day of the month.
Upon entry of the monthly data into NHSN for the
eligible location types, an estimate of
central-line days or urinary-catheter days is
automatically calculated and used as CLABSI and
CAUTI denominator data for the month. The next
slide shows an example of the data entry screen.
This is an example of the data entry screen for
"Denominators for Intensive Care Unit/ Other
Locations (not NICU or SCA)." A new data entry
section has been added to the right of the
screen that allows for the entry of sampled
denominator data. If your hospital has used the
sampling protocol for this location and month,
you must first check the boxes to the far right
for each device day count that was sampled.
Then you must enter the sampled patient
days and device days.
Once these fields are completed, the NHSN
application calculates the total central line
days and/or urinary catheter days for the month.
Remember, the total patient days - as collected
on every day of the month - are still required.
To ensure the accuracy of the estimated
denominator data, only non-oncology ICU and ward
location types with 75 or more device-days per
month are eligible to use the alternative method.
A review of each location's prior year of CLABSI
or CAUTI denominator data in NHSN will help
determine which locations are eligible.
The traditional method, that is, using every day
of a month, for CLABSI and CAUTI denominators
remains available for all NHSN users. The new
alternative method of data collection was tested
rigorously in a variety of NHSN locations; we
sincerely thank the participating facilities for
their efforts to help facilitate this change. More
detailed instructions on using the alternative
method are included in the 2015 NHSN Manual.
The rate table output options in NHSN can be
used to obtain the total number of device days
per location for the prior year. Specifically,
you will want to MODIFY the Rate Table
for CLABSI and CAUTI data.
Each rate table should be modified so that the
results include one rate, per location, per
year. For example, if you wish to assess the
average monthly device day count for the
calendar year 2014, you would need to modify the
rate tables to include only 2014 data, and group
by summary Year. If you would like to assess a
different 12 month time period, such as June
2014 through May 2015, then the Group By option
must be left blank.
Here's an example of annual rates for two
locations, produced by modifying the "Rate Table
- CLAB Data for ICU-Other" with the
modifications listed on the previous slide. The
average number of monthly central line days can
be calculated by dividing the total number of
central line days, per location, by the number
of months reported -12. For 22ICU, the average
number of monthly central line days for 2014 is
71.92; since this is less than 75, the new
denominator sampling protocol cannot be used.
For MICU, the average number of monthly central
line days for 2014 is 291.25; since this is well
above 75, the denominator sampling method for
central line days can be used for this location.
CLABSI and CAUTI analysis datasets and output
options are modified in 2015 so that facility
and group users can identify those months in
which the new denominator sampling protocol was
used. Specifically, variables are added to the
"Line List - All Summary Data" and variables are
added to the analysis datasets for the
applicable rate tables and Standardized
Infection Ratios, or SIRs. While the variables
are added to the rate table and SIR analysis
datasets, they will not appear in the resulting
rate table and SIR output. Therefore, users will
need to export the analysis dataset for this
detail. In addition, a footnote is added to
applicable tables in rates and SIRs when at
least one month of data was reported using the
denominator sampling protocol.
Additional resources can be found on the
NHSN website and on the Analysis
Quick Reference Guide site.
This concludes the NHSN Hot Topics update
focusing on device-associated denominator
sampling for 2015. For questions, please
contact NHSN user support at nhsn@cdc.gov.