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Healthcare-associated Infections: 2015 SIRs Using Historical Baselines

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English


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  • Description:
    The Centers for Disease Control and Prevention's (CDC's) National Healthcare Safety Network (NHSN) developed and uses standardized infection ratios (SIRs) to measure healthcare-associated infection (HAI) incidence. Each SIR is a summary statistic that compares the number of observed HAIs in a facility, state, or nation, to the number of predicted HAIs based on a national baseline. When the SIR is less than one, fewer infections were observed than predicted indicating progress in HAI prevention. Since 2009, CDC has calculated SIRs for select HAI types using historical national baselines, which varied by infection and facility type. The historical baselines remained constant for several years, allowing CDC and other organizations to measure progress and assess changes in HAI incidence from a single starting point in time. State and national SIRs have been published annually by CDC in the National and State HAI Progress Report, which summarizes the progress in HAI prevention compared to the historical national baselines, and compared national and state SIRs to those from the prior year.

    CDC performs regular reviews of the HAI definitions used in NHSN and works to improve these definitions based on new scientific evidence and user feedback. Recently, NHSN user concerns about the objectivity and specificity of some HAI definitions prompted CDC to introduce modified versions of those definitions, most notably in 2015. Because of these major changes, the HAI predictive models used to calculate the predicted number of infections in the SIR denominators needed to be updated using HAI data reported to NHSN in accordance with the recently modified HAI definitions. CDC opted to develop new SIR baselines using the 2015 HAI data that healthcare facilities reported to NHSN because by then all recent HAI definitional changes were in use. An important result is the new baselines, established using 2015 HAI data, reflect more recent national HAI experience and prevention efforts than the initial set of baselines. However, another important result is that direct comparisons of SIRs calculated using the old and new baselines-in effect, comparisons of HAI summary statistics in which different sets of HAI definitions and predictive models are used-are less readily interpretable than comparisons of SIRs using the same baseline. The result is that the 2015 HAI data reported by CDC as SIRs marks the start of a new reporting period, during which CDC and other organizations can measure HAIs at the facility, state, and national levels compared to the 2015 national HAI experience. Eventually, CDC will need to update the new baselines-periodic rebaselining is an inherent requirement of a comparative statistic in which data from a prior time period provides the basis for the comparison-but CDC's goal is to defer each update for as long as possible and replace baselines only when the need for replacement is imperative.

    CDC's 2015 National and State HAI Data Report will provide 2015 SIRs calculated using the 2015 national baseline and risk adjustment. This report will provide national and state-specific snapshots of HAIs in 2015, compared to the national 2015baseline. The 2015 HAI Data Report will be the first to measure HAIs with the 2015 baseline; therefore, the results in this report cannot be compared to SIRs from earlier years. CDC recognizes the importance of continuously monitoring HAIs over time in order to assess progress, identify opportunities for prevention, and provide actionable data each year. To that end, this paper will offer a 2015 national snapshot of select HAIs in acute care and critical access hospitals using SIRs calculated with the historical national baselines and risk adjustment methods such that comparisons can be made between 2015 and 2014. However, due to the numerous protocol and HAI definition changes made since the historical baseline time periods, caution should be used when interpreting 2015 SIRs calculated with the historical baselines, as these SIRs may reflect (to some extent) changes in reporting protocols rather than a true reflection of changes in HAI incidence. For these reasons, CDC discourages regional or facility-level comparisons between 2015 and 2014 SIRs, and would recommend caution when drawing any conclusions about national progress in 2015 using SIRs calculated with the historical baseline. Details of major protocol changes and their potential impact on the 2015 SIRs are described below by HAI type.

    This paper provides a summary of the 2015 national SIRs using the historical baselines for select HAI types. The data and methods used in this analysis are consistent with those published by CDC in the previous National and State HAI Progress Report. National SIRs in this analysis may differ from those presented on the Centers for Medicare and Medicaid Services' (CMS) Hospital Compare website due to differences in reporting facilities and patient care locations, reporting deadlines, and/or risk adjustment methodology. These analyses used data reported to NHSN no less than six months following the end of each calendar year.

  • Subjects:
  • Keywords:
  • Series:
    Healthcare-Associated Infections Progress: Reports
  • DOI:
  • Publisher:
    Centers for Disease Control and Prevention (CDC) (U.S.)
  • Document Type:
    Text
  • Name as Subject:
    National Healthcare Safety Network (NHSN)
  • Genre:
  • Place as Subject:
    United States
  • License:
  • Rights:
    Public Domain
  • CIO:
    National Center for Emerging and Zoonotic Infectious Diseases (NCEZID)
  • Division:
    DHQP - Division of Healthcare Quality Promotion
  • Topic:
    Diseases & Conditions
  • Location:
    North America
  • Pages in Document:
    10 pdf pages
  • Volume:
    2015
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:bd211673cad434e80fd5176b16e0ce211b7da150f02f2c9fa639506dacd17791089388fba080804208629995328431409677684107518825900f7a796b972d41
  • Download URL:
  • File Type:
    Filetype[PDF - 446.41 KB ]
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