Friday, April 22, 2011

Updates from NHSN

Updates from NHSN about HAI Reporting

I recently returned from the SHEA conference where I attended as many sessions as I could that dealt with NHSN’s thoughts about current or future reporting. You will be happy to know that someone has heard IP’s cries of pain when it comes to the amount of time that we spend on data collection! Here are some of the specific messages from the forums I attended.

The overall theme was that NHSN has a mandate (that they call their Action Plan) to reduce the time, effort and money spent on surveillance. They spoke several times about the need to (a) provide definitions that will track the effects of interventions, (b) will have clinical as well as surveillance meaning, and (c) will give IPs more time on clinical units helping patients and staff to improve care.

They will be issuing a new SSI form as soon as OMB approves it. They have changed the form so required data is more relevant to specific surgeries. For instance, information about implants will be required for orthopedic procedures but not for hysterectomies.

NHSN is currently having consensus meetings to finalize the criteria for VAP. They expect to have a statement by mid-summer. It will then take them some time to develop the software for NHSN submission. They expect that VAP reporting will become “mandatory” no sooner than January 1, 2013.

The biggest changes they are considering related to the definition of VAP include:

- making the chest x-ray a confirmatory finding rather than a key criterion of the definition,

-specifying PEEP settings and FiO2 readings as the specific indicators for worsening gas exchange, and

- specifying the time on a vent at 4 or more days before considering pneumonia as a possibility.

The SHEA forums with NHSN content were very satisfying. For the first time in memory the phrase “I’m the government and I’m here to help” wasn’t the introductory joke of the sessions.

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