Analyzing Data in NHSN

Transcription

1 Analyzing Data in NHSN Lindsey Weiner, MPH Epidemiologist Alabama Hospital Quality Initiative Webinar September 16, 2015 National Center for Emerging and Zoonotic Infectious Diseases Division of Healthcare Quality Promotion

2 Outline Basic introduction to NHSN analysis Frequently asked questions throughout the presentation Live demo of how to run and modify analysis reports Time available at the end for Q&A

3 Your Data are Important! Data entered into NHSN are used for national, aggregate analyses published in CDC annual reports 1. Annual Device-Associated Rate Report (national benchmarks) 2. HAI Progress Report 3. Antimicrobial Resistance Report May also be used by your state health department, your hospital s corporation/quality improvement organizations SIRs are used by CMS for quality reporting programs and are publicly available on Hospital Compare Important to regularly check and confirm data accuracy!! *using the NHSN Group function. Contingent on accepting rights template.

4 Why Analyze? Analysis tools within NHSN help facilitate internal validation activities Reports generated from NHSN can help inform prioritization and success of prevention activities At the end of the day, these are YOUR data you should know your data better than anyone else. Take ownership and discover how your data can tell a story about your facility!

5 NHSN Analysis Tools Analysis output options were created to allow facilities and groups to review their data, assess trends, and check for accuracy Use CMS-specific output options to review data that will be submitted to CMS prior to quarterly deadlines Quick Reference Guides on each analysis output:

6 Analysis Output Options Various output options available for each event type: Line lists Frequency tables Bar charts Pie charts Rate tables Run charts SIR tables Detailed analyses (e.g., event-level, procedure-level) Summarized analyses Each can be modified to meet your analytic needs Data can also be exported for further manipulation outside of NHSN

7 FAQ from the NHSN Helpdesk Is there a way that I can practice using NHSN analysis?? I am not very familiar with NHSN Analysis, and I would like to practice using these analysis options before I begin analyzing data in my facility. Is this possible?!

8 Yes, with NHSN Demo A copy of the NHSN application used to explore functionality Entering summary data, event data, monthly reporting plans, etc. Different facility types General Acute Care, Long Term Acute Care, Inpatient Rehab, Outpatient Dialysis, Long Term Care Fictitious data have been pre-loaded into Demo for analysis practice Analysis exercises available for the Acute Care hospital Reserve Demo in advance for large trainings Register for Demo on our website:

9 Demo Registration

10 GENERATING DATASETS

11 Generating Datasets Generating datasets is the first step in performing analysis in NHSN Copies and freezes data Makes your data available for the analytic reports Data are frozen as they are CURRENTLY entered into NHSN Analytic reports will NOT capture any new data entry/updates made since the last time you generated datasets Each user has his/her own analysis datasets

12 Generating Datasets Before analyzing data, generate new datasets (Analysis Generate Datasets) to integrate any recent data entry or editing By default, datasets will generate for the three most recent full calendar years, through the current date.

13 FAQs from the Helpdesk Q: If I generate datasets, will I be able to analyze the data that were entered by my colleagues? Or can I only analyze the data I've entered? A: Yes. While each user must generate their own datasets, the dataset will include ALL data in your facility, even those that were entered by other users.

14 ANALYSIS OUTPUT AND LIVE DEMO

15 Analysis Output Options To access the output options tree view, navigate to Analysis > Output Options The output options are organized into folders, first by module (e.g., Device-associated Module)

16 Live Demo Example Our hospital administrator would like more information about CLABSI events that occurred in any ICU in the hospital during the first 6 months of You decide that a CLABSI line list is the best way to present this information. She specifically asked to have this information presented in such a way as to see the data from each ICU separately (i.e., separate line list for each ICU).

17 Line Lists Allow record-level review of each event entered into NHSN Can be customized in NHSN to fit your needs Add/remove variables Change the time period or locations included Organize the line list using different factors

18 LINE LIST LIVE DEMO Our hospital administrator would like more information about CLABSI events that occurred in any ICU in the hospital during the first 6 months of 2015.

19 Another Way to Present These Data: Frequency Table Allows you to obtain counts of records meeting certain criteria Available for each specific event type Example: How many VAE events are classified as probable VAP in the ICU? Example: How many CDI LabID events are categorized as Community-Onset? Example: How many CLABSI events occurred in each ICU?

20 CLABSI Frequency Table How many CLABSI events occurred in each ICU?

21 Live Demo Example #2 You are now interested in knowing your hospital s overall CLABSI rate for each ICU for the first 6 months of Hospital has 3 ICU locations: Neurology ICU Medical/Surgical ICU Oncology Med/Surg ICU

22 Device-Associated (DA) Infection Rates Infection rates are calculated for device-associated infections (CLABSI, CAUTI, VAP/VAE) as an Incidence Density Rate Incidence Density Rate is known as the IDR : Numerator = # of new cases during a specific time period Denominator = person-time (device days) during the same time period (represents those at risk of acquiring specific infection) Multiplier helps us with interpretation

23 CLABSI Rate Example of CLABSI Rate calculation: # of CLABSIs in ICU for Jan-June x 1000 # of central line days in ICU for Jan-June 2015 Rates are calculated for each type location (e.g., med/surg ICU)

24 NHSN Rate Tables Displays the location s calculated rate for a given time period Provides a comparison of your facility s rate to the national benchmark National benchmark updated each year with most recent data National CLABSI rate for all Burn ICUs Facility s burn ICU CLABSI rate

25 More on NHSN Rate Tables By default, the rate tables will also show you the device utilization ratio for that location Device-utilization (DU) ratios describe the proportion of all patients that were using a device (central line, urinary catheter, etc.) for a specific time period and location Example: # of central line days in ICU # of patient days in ICU

26 Central Line Utilization National burn ICU central line utilization Facility s burn ICU central line utilization

27 RATE TABLE LIVE DEMO You are now interested in knowing your hospital s overall CLABSI rate for each ICU for the first 6 months of 2015.

28 FAQs from the Helpdesk Where can I EASILY find the national benchmarks from NHSN? The national benchmarks are automatically included in the NHSN rate tables, but what if I want to see the benchmarks without logging into NHSN?

29 National Benchmarks The Annual Rate Report includes national rates and device utilization ratios for CLABSI, CAUTI, and VAP Posted on the NHSN website. You can view full report as a PDF, or view the data tables alone.

30 FAQ from the Helpdesk Q: The Rate Table only shows me a rate for a single time period. How can I tell if a location s rate has significantly increased or decreased over time? A: The NHSN Statistics Calculator will allow you to compare rates or device-utilization ratios over time

31 Statistics Calculator The statistics calculator will compare two rates, ratios, or proportions and return a calculated p-value Useful for internal rate comparisons and to look for trends in device-associated infection rates Can be used for those locations without an NHSN pooled mean More information on the Statistics Calculator can be found here:

32 Thank you! For more information please contact Centers for Disease Control and Prevention 1600 Clifton Road NE, Atlanta, GA Telephone, CDC-INFO ( )/TTY: Web: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. National Center for Emerging and Zoonotic Infectious Diseases Division of Healthcare Quality Promotion