infection prevention and nhsn webinar series nhsn ...oct 23, 2018 · • surgical site infections...
TRANSCRIPT
An Initiative of the Florida Hospital AssociationHospital Improvement Innovation Network
Infection Prevention and NHSN Webinar SeriesNHSN: Surgical Site Infection (SSI) Surveillance Identification and AnalysisOctober 23, 2018
• Welcome & FHA Mission to Care HIIN Overview– Cheryl Love, RN, BSN, BS-HCA, MBA, LHRM, CPHRM, Director of
Quality and Patient Safety and Improvement Advisor, FHA
• NHSN: Surgical Site Infection (SSI) Surveillance Identification and Analysis– Linda R. Greene, RN, MPS, CIC, FAPIC, Manager of Infection
Prevention, UR Highland Hospital, Rochester, NY
• Q&A• Upcoming HIIN Events and Opportunities• Evaluation Survey & Continuing Nursing Education
Agenda
• Adverse Drug Events (ADE)• Catheter-associated Urinary Tract Infections (CAUTI)• Clostridium Difficile Infection (CDI)• Central line-associated Blood Stream Infections (CLABSI)• Hospital-onset MRSA Bacteremia• Injuries from Falls and Immobility• Pressure Ulcers (PrU)• Sepsis• Surgical Site Infections (SSI)• Venous Thromboembolisms (VTE)• Ventilator Associated Events (VAE/IVAC/PVAP)• Readmissions (12% reduction)• Worker Safety
HIIN Core Topics – Aim is 20% reduction
SSI Change Package
SSI Top 10 Checklist
SOAP UP Resources
Watch Past Webinars
HRET HIIN Resource Library
Guides
Case Studies
SSI Resources, Trainings and Toolshttp://www.fha.org/health-care-issues/quality-and-safety/mtc-hiin.aspx
http://www.hret-hiin.org
Simplify safe care and streamline interventions
Reduce multiple forms of harm with simple, easy-to-accomplish activities
Consolidate basic interventions that cut across several topics to decrease harm
UP Campaign
http://www.fha.org/up
FHA Mission to Care Update: SSI - Colon
Source: HRET Comprehensive Data System, October 22, 2018
BL 10/16 11/16 12/16 1/17 2/17 3/17 4/17 5/17 6/17 7/17 8/17 9/17 10/17 11/17 12/17 1/18 2/18 3/18 4/18 5/18 6/18 7/18
FL Rate 4.26 5.35 4.02 5.81 5.38 4.85 4.36 3.46 3.76 3.84 4.64 5.33 4.94 3.79 3.70 5.36 4.52 5.00 4.97 4.62 3.98 4.47 4.34
HRET HIIN Rate 5.15 4.71 4.67 4.81 4.89 4.54 4.55 4.18 4.73 4.61 4.56 5.06 5.13 4.70 4.58 4.96 4.91 5.39 4.79 4.75 4.69 5.05 4.70
# FL Reporting 82 81 81 80 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 79 76 65
#HRET HIIN Reporting 1,109 1,125 1,125 1,124 1,125 1,122 1,121 1,119 1,118 1,115 1,113 1,112 1,115 1,116 1,111 1,111 1,105 1,092 1,091 1,059 1,031 970 785
0.00
1.00
2.00
3.00
4.00
5.00
6.00
7.00
Rate
per
100
FHA Mission to Care Update: SSI - Hysterectomy
Source: HRET Comprehensive Data System, October 22, 2018
BL 10/16 11/16 12/16 1/17 2/17 3/17 4/17 5/17 6/17 7/17 8/17 9/17 10/17 11/17 12/17 1/18 2/18 3/18 4/18 5/18 6/18 7/18
FL Rate 1.47 1.29 2.08 0.62 0.74 0.92 0.78 0.99 1.34 1.42 1.49 1.06 1.15 1.10 0.96 1.15 0.45 0.69 1.07 1.04 1.17 0.40 1.51
HRET HIIN Rate 1.47 1.14 1.36 1.02 1.18 1.31 1.21 1.34 1.36 1.34 1.22 1.16 1.40 1.14 1.25 1.10 1.17 1.00 1.25 1.28 1.19 1.08 1.29
# FL Reporting 81 80 79 80 78 78 78 78 78 78 78 78 78 78 78 77 78 78 78 78 78 73 65
#HRET HIIN Reporting 1,066 1,081 1,082 1,083 1,077 1,077 1,081 1,073 1,076 1,073 1,070 1,068 1,071 1,072 1,068 1,064 1,062 1,034 1,034 1,015 987 930 757
0.00
0.50
1.00
1.50
2.00
2.50
Rate
per
100
FHA Mission to Care Update: SSI - Knee
Source: HRET Comprehensive Data System, October 22, 2018
BL 10/16 11/16 12/16 1/17 2/17 3/17 4/17 5/17 6/17 7/17 8/17 9/17 10/17 11/17 12/17 1/18 2/18 3/18 4/18 5/18 6/18 7/18
FL Rate 0.77 0.87 0.56 0.67 0.50 0.72 0.46 0.60 0.49 0.47 0.81 0.41 0.46 0.59 0.85 0.31 0.50 0.47 0.51 0.69 0.60 0.29 0.24
HRET HIIN Rate 0.74 0.57 0.58 0.74 0.50 0.50 1.00 0.82 0.98 0.63 0.81 0.63 0.88 1.08 0.99 0.49 0.55 0.42 0.57 0.79 0.84 0.72 0.47
# FL Reporting 68 65 66 65 64 64 64 63 61 60 60 61 62 61 61 61 61 60 58 57 57 56 52
#HRET HIIN Reporting 828 834 834 833 867 863 866 863 863 861 856 849 856 856 853 851 845 836 824 791 754 710 576
0.00
0.25
0.50
0.75
1.00
1.25
1.50
Rate
per
100
FHA Mission to Care Update: SSI - Hip
Source: HRET Comprehensive Data System, October 22, 2018
BL 10/16 11/16 12/16 1/17 2/17 3/17 4/17 5/17 6/17 7/17 8/17 9/17 10/17 11/17 12/17 1/18 2/18 3/18 4/18 5/18 6/18 7/18
FL Rate 1.44 0.90 1.15 0.80 1.18 0.90 1.16 0.42 1.07 1.25 1.51 1.13 0.87 0.97 1.00 1.03 1.07 0.63 0.99 1.37 1.50 0.87 0.30
HRET HIIN Rate 1.21 1.00 1.18 0.99 1.04 1.17 1.13 1.18 1.31 1.01 1.26 1.06 1.26 1.26 0.98 1.14 1.22 1.00 1.20 1.12 0.97 1.27 0.70
# FL Reporting 67 64 65 65 64 64 64 63 61 60 60 61 61 61 61 61 61 60 59 57 57 57 52
#HRET HIIN Reporting 810 819 816 813 852 848 847 843 842 841 836 828 829 834 831 831 824 824 811 777 754 703 564
0.00
0.25
0.50
0.75
1.00
1.25
1.50
1.75
2.00
Rate
per
100
FHA Mission to Care Update:Florida | SSI Rates
Date Topic Register Online
Oct. 23 NHSN: SSI Surveillance Identification and Analysis (Virtual Event)
Today’s event archive will be posted online
Nov. 20 SSI-Colon: How to Assess Root Cause and Prevention Strategies (Virtual Event)
https://cc.readytalk.com/r/x6cg3sako1xq&eom
Dec. 4 Infection Prevention NHSN Workshop III –Orlando, FL (In-Person Event)
http://www.cvent.com/d/8bqwm5/2K
Dec. 18 NHSN topic to be announced (Virtual Event) https://cc.readytalk.com/r/ag8n7ef9vryt&eom
Infection Prevention and NHSN Webinar Series: 2018-2019
Access Event Archives (Recordings | Slides) on the Mission to Care HIIN Website
NHSN SSI Definitionsand Analysis
Linda R Greene, RN, MPS,CIC, FAPICManager Infection Prevention
University of Rochester, Highland [email protected]
RemindersNHSN Infection Window Period (Does NOT apply to SSI, VAE, or LabID Event surveillance) Date of Event (Event Date) (Does NOT apply to VAE or LabID Event surveillance) Repeat Infection Timeframe (RIT) (Does NOT apply to SSI, VAE, or LabID Event surveillance)
Polling Question #1Can the culture be used to meet SSI criteria?
Yes
No
Polling Question #2Does this case meet criteria for PATOS?
Yes
No
When in doubt – e-mail NHSN
Polling Question #3Does this case meet criteria for a superficial SSI?
No. The culture shows no growth
Yes. Meets SIP criteria
No. Meets DIP infection
No. Intact fascia
Analysis of Surgical Site Infections
What Information do I need today?
Helpful to run a line list
Variables
Other Variables
Recently Published Data 2016 Analysis
SIR = Observed infections
Expected infections
SIR0 1 2
SameBetter Worse
Standardized Infection RatiosRefresh our memory
https://www.cdc.gov/hai/data/portal/progress-report.html
Colon SSI Percentile Distribution
0.000 0.000 0.000 0.085 0.343 0.444 0.558 0.627 0.710 0.801
0.880 0.959 1.082 1.207 1.336 1.504 1.683 1.919 2.33755% 60% 65% 70% 75% 80% 85% 90% 95%
https://www.cdc.gov/hai/data/portal/progress-report.html
Looking Down the Road
Looking Down the Road
Check Procedures
Exclusions
Tips - Review
Tips Review your data.
Standardized review forms will help with consistency
Review Sheet
Opportunities for Improvement Use available data to drive improvement
NHSN provides a rich variety of information
Virtual Events:• Oct. 25 - HRET HIIN & CMS | Mapping Medicare Disparities• Nov. 1 - HRET HIIN | Multi-Drug Resistant Organism (MDRO) Discovery and
Direction Series: Organizational Risk Assessment• Nov. 7 - FHA HIIN | Hot Topics Monthly Virtual Event• Nov. 9 - HRET HIIN | Readmissions Multi Visit Patient (MVP) Webinar #2• Nov. 14 - HRET HIIN | Culture of Safety Virtual Event - Workplace Violence: Up Close• Nov. 15 - HRET HIIN | Falls Fishbowl #2• Nov. 15 - HRET HIIN | MDRO Discovery and Direction Series: Horizontal Practices• Nov. 20 - FHA HIIN | Infection Prevention & NHSN Series - SSI-Colon: How to
Assess Root Cause and Prevention Strategies• Nov. 29 - HRET HIIN | MDRO Discovery and Direction Series: Special Approaches
and Essential QuestionsIn-Person Event:• Dec. 4 (Orlando, FL) - FHA HIIN | Infection Prevention NHSN Workshop III
Upcoming HIIN Events
Check the weekly MTC HIIN Upcoming Events for details and registration
• Eligibility for Nursing CEU requires submission of an evaluation survey for each participant requesting continuing education:https://www.surveymonkey.com/r/IP-NHSN-102318
• Share this link with all of your participants if viewing today’s webinar as a group (Survey closes Nov. 2)
• Be sure to include your contact information and Florida nursing license number
• FHA will report 1.0 credit hour to CE Broker and a certificate will be sent via e-mail (Please allow at least 2 weeks after the survey closes)
Evaluation Survey & Continuing Nursing Education
Cheryl D. Love, RN, BSN, BS-HCA, MBA, LHRM, CPHRMFlorida Hospital [email protected] | 407-841-6230
Linda R. Greene, RN, MPS, CICManager of Infection PreventionUR Highland Hospital, Rochester, [email protected]
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