To ensure Oregon healthcare-associated infection data is accurately and completely reported, the Oregon Public Health Division is engaged in validation studies where results reported by hospitals are independently audited by Oregon state employees.
Central Line-Associated Bloodstream Infection (CLABSI) Validation and
Surgical Site Infection (SSI) Validation Studies
- Monitors accuracy of data submitted by hospitals to the National Healthcare
Safety Network (NHSN)
- Assesses hospital surveillance systems and their use of NHSN definitions
- Ensures that hospitals are reporting infections in a consistent fashion
A central line-associated bloodstream infection is a serious infection that occurs when bacteria or viruses enter the bloodstream through a central line. A central line is a catheter (tube) that healthcare providers place in a large vein in the neck, chest, or arm to provide fluids, blood, or medications. Central lines are also used to perform certain medical tests. Commonly found in an intensive care unit (ICU) setting, central lines are different from short-term intravenous catheter’s (IVs) in that they are often used to access a major vein close to the heart, and they can remain in place for weeks or even months, and are much more likely to cause a serious infection.
CLABSIs result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system, yet these infections are preventable. According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 250,000 CLABSI cases occur each year in U.S. hospitals, resulting in a range of 30,000 to 62,000 deaths. It is estimated that U.S. hospitals spend up to 2.68 billion dollars annually to manage CLABSI cases.
In 2011, the Oregon Public Health Division completed a statewide validation of ICU CLABSI data reported for 2009, the first reporting year, to determine the accuracy of data submitted by hospitals to NHSN. This validation project audited medical records of the 44 hospitals required to report CLABSI in 2009. Validation focused on assessing hospital surveillance systems and their use of NHSN definitions. Such validation projects ensure that hospitals are consistent in reporting CLABSIs so that an accurate assessment of CLABSIs in Oregon hospitals can be determined.
Currently, Oregon Public Health Division is performing a statewide validation of ICU CLABSI and denominator data during 2012 using a targeted sample of 23 Oregon hospitals. Study results will be reported in late 2014.
The Oregon Public Health Division (OPHD) is conducting a data validation study of coronary artery bypass graft (CABG) and surgical site infections occurring with patients hospitalized in Oregon due to procedures performed in 2009 and 2010. This procedure and time frame is chosen to establish a baseline for comprehensive validation of Oregon's reportable healthcare-associated infection data for SSIs.
A surgical site infection is an infection that occurs after surgery in the part of the body where the surgery took place. Though SSIs can sometimes be superficial infections, involving only the skin, other times SSIs can be deeper and involve tissues beneath the skin in organs, or implanted material. Although comprehensive validation of SSIs within the U.S. is relatively uncharted territory, other validation work abroad and in the U.S., as well as validation of other HAIs (e.g. CLABSIs), has indicated that validation of SSI data is necessary to ensure accurate hospital reporting.
OPHD’s SSI data validation efforts will provide a method to: monitor the accuracy of data submitted by hospitals to the NHSN, assess hospital surveillance systems, and help to evaluate the implementation of surveillance case definitions. Data from all 14 hospitals that reported CABG SSI data in 2009 and 2010 will be validated. The validation will take place between September 2011 and June 2012. The findings of this validation project will provide guidance to hospital staff on their use of surveillance definitions, reporting methods, and the NHSN.