# Presentation: 527428

## National Healthcare Safety Network (NHSN)

- Training Session
- for NNIS Hospitals
- December 9, 2004

**Notes:**

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## Agenda

- Issues from previous training session
- Enrolling your hospital – recap
- Deployment phases
- Training, support, and timeline
- NHSN Protocols
- Navigation Bar
- Plan
- Data Entry – Device-Associated Events
- Patient, Event, Summary
- Printing completed records
- Q & A

## Announcements

**FAQ document can be found on the NHSN website:**
- _[http://www.cdc.gov/ncidod/hip/nhsn/members/members.htm](http://www.cdc.gov/ncidod/hip/nhsn/members/members.htm)_

- The Enrollment Application has not yet been deployed.  We will notify you as soon as it is ready to be used.
- Do not apply for your digital certificate yet!
- Every NNIS Member who wishes to join NHSN must enroll using the process we’ve described. It is _not _automatic.
- Please have only NNIS Primary Contact  communicate with us.
- The December 14 training session is for current DSN members only.

## Very Important

- Make certain that your Information Systems will allow bulk email from CDC.  It is our only way to communicate with you!

## Enrollment -- Recap

- Download and print **Facility Contact Information** and **Hospital Survey** from NHSN website. Complete both forms by hand.
- When Enrollment site is available (we will notify you), enter the information from both forms and submit it. Close the browser.
- The person you listed as the contact for enrollment will be sent an email:

- From: NHSN
- Subject: NHSN Facility Enrollment Submitted
-  A new facility has been submitted for enrollment.
-                       Facility Name: Your hospital
-                     Tracking Number: ####
-                          Relevant Email Addresses
-              Facility Administrator: person1@address.xxx
-              Patient Safety Contact: person2@address.xxx
-    Healthcare Worker Safety Contact:
-         Agreement Recipient's Email: person1@address.xxx

- In the same email, you will receive a url to download and print an **Agreement to Participate. **Complete this form, get it signed by the appropriate administrators,  keep a copy and send the original through the mail to CDC (see Contact Information on the NHSN website)
- Once the signed **Agreement to Participate** has been received by CDC, we will activate your NHSN account and send you another email with instructions to obtain your digital certificate:

- Subject: Welcome NHSN Facility Administrator
- Welcome to NHSN! You have been added as a Facility Administrator for the following facility or group:
-                       Facility or Group Name: xxxxx
- In order to access NHSN, you will need to obtain and install a digital certificate onto the computer you plan to use for connecting to the NHSN.

- After the NHSN Facility Administrator has downloaded the digital certificate onto her/his computer, she/he can log into NHSN.

**Step-by-step instructions for enrollment are now available on the NHSN website, with screen shots and specific directions for each step.**

## NHSN v.1Deployment Phases

- Enrollment and Manage User (Dec 2004)
- Facility Set Up
- Set up location and surgeon codes; custom fields
- Patient Safety Events and Denominator Data Entry (Jan 2005)
- Analysis Functionality (Feb 2005)

## Training

- Net conferences that can be viewed live and will be archived on NHSN members website
- Scheduled topics
- Protocols; Data entry Device-associated events & denoms; Navigation bar; Plan
- Set up; Data entry Procedure-associated events & denoms; AUR; Plan
- Online help; Print; Groups; Legacy data
- Export; Data analysis (multiple sessions)

## NHSN Timeline

- Nov 2004-Feb 2005: Train and enroll current NNIS, NaSH, DSN members
- Jan 2005: Begin entering data into NHSN
- By Jan 31, 2005: Complete entry/transmission of 2004 NNIS data into IDEAS
- March 2005 – Train and enroll “sister” facilities
- Summer 2005 – Train and enroll others

## NHSN Protocols

- General Differences between NNIS and NHSN

## Surveillance Plan

|  |  |
| --- | --- |
| Required | Required |

## Forms

|  |  |
| --- | --- |
| One form for all infections | Specific form for each event |

## Definitions/Protocols

|  |  |
| --- | --- |
| Infection definitions
Data collection protocols
ICD-9 codes used to define operative procedure categories | Infection definitions
Small refinements in data collection protocols
Refinements in Operative Procedure Codes
 |

**CDC’s National Nosocomial Infections Surveillance (NNIS) System**

**NNIS System**

**AUR**

**ICU**

**HRN**

**Surgical**
**Patient**

- Antimicrobial
- Use and
- Resistance

- Intensive Care
- Unit
- (Adult/Pediatric)

- High Risk
- Nursery
- (NICU)

## Population

|  |  |
| --- | --- |
| ICU
High Risk Nursery  | ICU
High Risk Nursery
Any patient care location
Specialty Care Areas (SCA)
Bone Marrow Transplant
Solid Organ Transplant
Acute Dialysis Unit
Hematology/Oncology |

## Numerator

|  |  |
| --- | --- |
| All infections | Selected device-associated infections only
CAUTI and/or
CLAB and/or
VAP
 |

## Denominator

|  |  |
| --- | --- |
| For each ICU Patient days
Patient days
All 3 types of device days
For each HRN (by birthweight)
Patient days
2 types of devices

 | For each patient care area monitored
Patient days
1-3 types of device days
In Specialty Care Area (SCA), split central lines into temporary and permanent
In HRN, 5 birthweight categories
Umbilical catheter and central line separately
 |
|  |  |

## Microbiology

|  |  |
| --- | --- |
| Up to 4 pathogens
Complete antibiogram required with all sensitivities | Up to 3 pathogens
Specific antibiograms for certain pathogens
Increased flexibility – you can enter as many agents as you need (up to 20 per bug)
Order entry is flexible |

## NHSN Protocols

- Device-Associated Module
- Dialysis Incident

## Dialysis Protocols

| Population | Dialysis outpatients |
| --- | --- |
| Numerator | Complete form for each dialysis incident
Hospitalization
Outpatient IV antimicrobial start
Positive blood culture |
| Denominator | Number of dialysis outpatients on the first 2 working days of the month
Stratified by 5 types of vascular access |
| Microbiology |  Same as other NHSN components |

## Questions?

## Support

- Online help messages within NHSN
- Email:  nhsn@cdc.gov
- Phone support:
- 	800-893-0485 or 404-498-1250
- Members website:
-  www.cdc.gov/ncidod/hip/nhsn/members/members.htm

## Thank You!

**Thank You!**

**A few of the CDC NHSN staff**

## Questions?