Infection Prevention and NHSN Webinar Series NHSN: Surgical Site - - PowerPoint PPT Presentation

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Infection Prevention and NHSN Webinar Series NHSN: Surgical Site - - PowerPoint PPT Presentation

Aug 20, 2023 40 likes •670 views

An Initiative of the Florida Hospital Association Hospital Improvement Innovation Network Infection Prevention and NHSN Webinar Series NHSN: Surgical Site Infection (SSI) Surveillance Identification and Analysis October 23, 2018 Agenda

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An Initiative of the Florida Hospital Association Hospital Improvement Innovation Network

Infection Prevention and NHSN Webinar Series NHSN: Surgical Site Infection (SSI) Surveillance Identification and Analysis

October 23, 2018

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  • 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

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  • 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

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 SSI Change Package  SSI Top 10 Checklist  SOAP UP Resources  Watch Past Webinars  HRET HIIN Resource Library  Guides  Case Studies

SSI Resources, Trainings and Tools

http://www.fha.org/health-care-issues/quality-and-safety/mtc-hiin.aspx http://www.hret-hiin.org

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  • Simplify safe care and

streamline interventions

  • Reduce multiple forms
  • f 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

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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

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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

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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

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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

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FHA Mission to Care Update: Florida | SSI Rates

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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

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NHSN SSI Definitions and Analysis

Linda R Greene, RN, MPS,CIC, FAPIC Manager Infection Prevention University of Rochester, Highland Hospital Linda_greene@urmc.rochester.edu

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Reminders

NHSN 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)

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Polling Question #1

Can the culture be used to meet SSI criteria?

 Yes  No

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Polling Question #2

Does this case meet criteria for PATOS?

 Yes  No

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When in doubt – e-mail NHSN

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Polling Question #3

Does 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

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Analysis of Surgical Site Infections

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What Information do I need today?

Helpful to run a line list

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Variables

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Other Variables

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Recently Published Data 2016 Analysis

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SIR = Observed infections Expected infections

SIR 1 2

Same Better Worse

Standardized Infection Ratios Refresh our memory

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https://www.cdc.gov/hai/data/portal/progress-report.html

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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 2.337

55% 60% 65% 70% 75% 80% 85% 90% 95%

https://www.cdc.gov/hai/data/portal/progress-report.html

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Looking Down the Road

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Looking Down the Road

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Check Procedures

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Exclusions

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Tips - Review

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Tips

Review your data.

 Standardized review forms will help with consistency

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Review Sheet

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Opportunities for Improvement

 Use available data to drive improvement  NHSN provides a rich variety of information

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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 Questions

In-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

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  • 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

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Cheryl D. Love, RN, BSN, BS-HCA, MBA, LHRM, CPHRM Florida Hospital Association cheryll@fha.org | 407-841-6230 Linda R. Greene, RN, MPS, CIC Manager of Infection Prevention UR Highland Hospital, Rochester, NY linda_greene@urmc.rochester.edu

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