Lindsey Weiner, MPH Epidemiologist
Analyzing Data in NHSN
National Center for Emerging and Zoonotic Infectious Diseases Division of Healthcare Quality Promotion
Alabama Hospital Quality Initiative Webinar September 16, 2015
Outline
Basic introduction to NHSN analysis
Frequently asked questions throughout the
presentation
Live demo of how to run and modify analysis reports
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!!
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
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:
http://www.cdc.gov/nhsn/PS-Analysis-resources/reference-guides.html
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
Each can be modified to meet your analytic needs
Data can also be exported for further manipulation
outside of NHSN
Detailed analyses (e.g., event-level, procedure-level)
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?! “
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:
Demo Registration
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
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.
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.
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
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 2015.
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).
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
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.
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
CLABSI Frequency Table
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 2015.
Hospital has 3 ICU locations:
Neurology ICU
Medical/Surgical ICU
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)
CLABSI Rate
Example of CLABSI Rate calculation:
# of CLABSIs in ICU for Jan-June 2015
--- x 1000 # of central line days in ICU for Jan-June 2015
Rates are calculated for each type location (e.g.,
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
Facility’s burn ICU CLABSI rate
National CLABSI rate for all Burn ICUs
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
Central Line Utilization
National burn ICU central line utilization
Facility’s burn ICU central line utilization
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.
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?
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.
http://www.cdc.gov/nhsn/datastat/index.html
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
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:
For more information please contact Centers for Disease Control and Prevention
1600 Clifton Road NE, Atlanta, GA 30333
Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348
E-mail: [email protected] Web: www.cdc.gov
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.
Thank you!
[email protected]
National Center for Emerging and Zoonotic Infectious Diseases Division of Healthcare Quality Promotion
