>> Welcome to the 2021 National Healthcare Safety Network, or NHSN, quick learn series.
These are brief and informative sessions from the Centers for Disease Control and Prevention.
They serve as an educational resource for healthcare facilities working
to prevent healthcare associated infections, or HAIs.
In this quick learn, we describe the differences between total ventilator-associated events,
or Total VAE, and infection related ventilator associated complication plus,
or IVAC+ events with respect to analysis.
In this quick learn, we will define and demonstrate the differences
between Total VAE and IVAC+ events.
By the end of this lesson, you will be able to distinguish Total VAE from IVAC+ events,
navigate the NHSN application to run and analyze reports for Total VAE and IVAC+ events,
and interpret Total VAE from IVAC+ events line lists and SIR reports.
We will go through the identification steps of Total VAE and IVAC+ events.
The VAE algorithm is progressive in terms of criteria to be met,
wherein a ventilator associated condition event must be met before identifying an infection
related ventilator associated complication, or IVAC, event.
And the IVAC event must be met before identifying a possible ventilator associated
pneumonia, or PVAP, event.
Total VAE events include those events identified as VAC, IVAC, and PVAP.
IVAC+ events include those events identified as IVAC and PVAP.
Rates and SIR are the statistical measures available in NHSN for HAI events.
Among these, SIR is the most popular measure used to track Total VAE and IVAC+ events
at the national, state, or local level over time.
Total VAE rates or SIR represent all VAE events that met at least the VAC definition.
These measures would be suitable for benchmarking, inter-facility comparisons,
pay for performance, or pay for reporting programs such as CMS programs.
This is because all facilities should be able to detect VAC in a standardized manner.
IVAC+ rates or SIR represent all events that met at least the IVAC definition.
These measures would be suitable for intra-facility comparisons
or for internal quality improvement measures.
This is because IVAC detection may be influenced by differences in antimicrobial stewardship
which can vary widely from facility to facility.
We will now see the steps involved in the generation
of analysis reports within the NHSN application.
First, we will see the line listing all VAE analysis report.
After generating the data sets, access reports from the left navigation bar
which will then display the analysis reports page.
Select ventilator associated events under the device associated module.
Then select line listing all VAE followed by selecting run report.
On this slide, we see the fictional data and the line list
of Total VAE events generated for this data in NHSN.
VAE is the event type, wherein any of these specific events such as VAC, IVAC,
and PVAP qualify as a Total VAE event.
The event should meet at least the VAC definition.
Total VAE infection count in this line list, as highlighted, is eight.
Here, we see the same line list as in the previous slide.
However, this line list identifies IVAC+ events as highlighted.
In the specific event column, six out of the eight events qualify as IVAC+ infections.
Where the event meets at least the IVAC definition.
IVAC+ infection count in this line list, as highlighted, is six.
In the next few slides, we will go through the SIR reports
for VAE data from acute care hospitals.
Under the analysis reports, select ventilator associated events
in the device associated module.
Then select SIR for ventilator days, acute care hospital VAE data,
followed by selecting run report.
There are four types of SIR tables each for Total VAE and IVAC+ events separated
by med type and NHSN analysis reports.
They are classified as SIR tables by Org ID, by org ID location type,
by org ID CDC location code, and by org ID location.
We will review one of these table types in upcoming slides.
In this slide, we will understand the variable MedType used in the classification
of Total VAE and IVAC+ events SIR tables.
An NHSN facility can be a teaching or a non-teaching facility.
An NHSN facility has the medical school affiliation status if it is a teaching facility.
MedType describes the medical school affiliation status of an NHSN teaching facility.
MedTypes can be one of the following: major, it is a facility that trains medical students,
nursing students, and/or post-graduate students.
Graduate, a facility that trains only post-graduate medical residents or fellows.
Undergraduate, facility that trains undergraduate medical students and/or
nursing students.
In this example, SIR tables are classified by org ID
for the graduate medical school affiliation which is MedType is equal to G.
On the left is the Total VAE SIR table.
The SIR is calculated using the Total VAE SIR model for acute care hospitals.
And on the right is the IVAC+ SIR table.
The SIR is calculated using the IVAC+ SIR model for acute care hospitals.
For the same line list, infection count, number of predicted infections,
SIR and associated SIR statistics vary between the two tables as highlighted.
In a similar fashion, the rest of the SIR table types are also generated.
To summarize, we have covered the following concepts in this Quick Learn:
To distinguish between Total VAE and IVAC+ events; to navigate NHSN to analyze reports,
for example line list, SIR tables for Total VAE and IVAC+ events;
and finally to interpret the analysis reports of Total VAE and IVAC+ events.
Following are some of the additional resources available on the NHSN website
to understand the concepts covered in this quick learn.
An updated SIR guide can be accessed from the provided link.
And links to the 2021 annual NHSN VAE training slides are provided as well.
This brings us to the end of the difference between Total VAE
and IVAC+ events for analysis quick learn.
If you have any additional questions or concerns,
please contact the NHSN helpdesk at nhsn@cdc.gov.
Thank you.