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Hospital Acquired Infections (HAIs) in South Carolina

2011 - HIDA Hospital Acquired Infections (HAI) Public Reports

This web page contains links to the following documents and reports:

 


Hospital Infections Disclosure Act (HIDA)
Hospital Acquired Infections Reports

Individual Hospital's HIDA HAI Reports

  • Alphabetical order by the hospital name.
  • Number of licensed general beds (excludes psychiatric and substance abuse beds).
  • Average daily census for general beds
  • Number of surgical procedures performed, number of infections, (SSI) rates for each reportable surgical procedures and separated by surgical risk category
  • Number of central line days, number of central line associated bloodstream infections (CLABSI), and CLABSI infection rates in defined “locations” (patient care units) within each hospital

*Comparison Reports by HAIs: (New for 2010: Comparison Reports for the number of SSIs may show a lower number of infections than those shown in the Individual Hospital SSI Reports. See explanation below.)

How are hospital HAIs compared?

Hospitals are not compared with other hospitals in South Carolina.  Each individual hospital’s infection rates for the reportable HAIs are compared with the historical experience in the standard population of all NHSN users in the United States.

In the Comparison reports, hospital SSI and CLABSI reports are compared using the Standardized Infection Ratio (SIR) which is a summary measure used to compare the HAI experience among one or more groups of patients to that of a standard population. It is the observed number of infections divided by the expected (predicted) number of infections. The term “expected” means that when looking at the national rate of infections you would expect (or predict) a certain number of infections.  “Expected”* is based on historical data for those procedures at the national level. It is, in effect, a national rate of infections found in the hospitals reporting to NHSN.

For CLABSIs, SIRs can be calculated based on the “pooled mean” or historic average for the standard population of NHSN users.  The pooled mean for this report is based on the most recent data and included in the following journal article: “National Healthcare Safety Network (NHSN) report: Data summary for 2006 through 2008, issued December 2009” published by the Association for Professionals in Infection Control and Epidemiology (APIC) found in the American Journal of Infection Control.

Individual hospital reports present each facility’s total SSI count, by procedure. Data in the comparison reports is based on the CDC new methods for calculating SSI SIRs that allow for better risk adjustment and a better way to compare SSI SIRs among facilities. The complex SSI SIR for this report is based on the most recent CDC recommendation in the following NHSN e-News: SIRs Special Edition  

Complex SSI SIRs were calculated using only inpatient procedures and deep incisional primary and organ/space SSIs that were identified during admission or readmission to the facility. The number of infections listed in the individual hospital reports may vary from the number of infections listed in the comparison report as some infections may not have met the specific criteria required to be included in the Complex SSI SIR calculation.

Each HAI Compare Table has a link to the Definition of Terms for Standardized Infection Ratio and Confidence Intervals and additional information about HAI reports.

 Comparison Tables contain the following information for each hospital listed:  

  • Name of hospital
  • Number of infections
  • Number of surgical procedures or central line days
  • The hospital’s statistically “expected” number of SSIs
  • Hospital’s SIR “observed / expected (predicted) Standardized Infection Ratio (SIR)
  • 95% Confidence Interval for each hospital’s SIR
  • Interpretation of the hospitals SIR
    • Not different = Statistically similar (not different) than the standard population
    • Lower = Statistically lower than the standard population
    • Higher = Statistically higher than the standard population


HAI Compare - Tables for HIDA Reporting Requirements:
January 1, 2011 – December 31, 2011

2011 Comparison Summary Data for Hospital HAIs: Standardized Infection Ratio (SIR) Report by Surgical Site Infections (SSI) Procedures and Central Line Locations

Introduction:  Surgical Site Infections

SSI rates are adjusted to take into account differences in patient risk factors for infection due to length of the surgery, type of surgical wound and the patient's physical condition. Many SSIs from these types of surgeries can be prevented by following defined prevention methods.

Surgical site infections (SSIs) are infections that:

  • are directly related to an operative procedure
  • occur in the part of the body where the operation took place
  • may be minor or serious
  • occur within 30 days if there is no implant or within one year if there is an implant.

SSI Reporting Changes:  DHEC, with the advice of the HIDA Advisory Committee, selected the surgical procedures for mandatory public reporting of SSIs from the National Healthcare Safety Network (NHSN) system. Over time, procedures have been added to or rotated off the reporting schedule.   

Currently, DHEC is monitoring the following surgical procedures:

Cardiac (Thoracic) Surgeries:

Heart Bypass (Coronary Artery Bypass Grafts):
Heart bypass or coronary artery bypass graft (CABG, pronounced cabbage) is a surgery used to bypass blocked heart arteries by creating new passages for blood to flow to the heart muscle. Arteries or veins from other parts of the body are used as grafts to create alternative blood-flow pathways.  There are two types of heart bypass surgeries and these are reported separately.  These are the grafts with chest and donor incisions (CABG), and the graft with chest incision only (CBGC).

Orthopedic Surgeries:
 
Total or Partial Hip Replacements:
Hip replacement is surgery for people with severe hip damage or pain related to chronic osteoarthritis, rheumatoid arthritis or other degenerative processes involving the hip joint. The surgical procedure for a hip replacement involves removing the damaged cartilage and bone from the hip joint and replacing them with new, man-made parts.

Total or Partial Knee Replacements:
Knee replacement surgery (arthroplasty) is an elective procedure for people with severe knee damage and pain related to osteoarthritis, rheumatoid arthritis, and traumatic arthritis. A total knee replacement involves removing the damaged cartilage and bone from the surface of the knee joint and replacing them with a man-made surface of metal and plastic. A partial knee replacement involves replacing only part of the knee joint.

Abdominal Surgeries:

Hysterectomy:
Hysterectomy (abdominal) is the removal of the uterus through an abdominal incision.

Colectomy:
Colon surgery includes incisions, removal, and reconnection of the small and large bowel. It does not include rectal operations. (Reportable only by hospitals with 200 licensed beds or less.)  


Reports: Surgical Site Infections

Surgical Site Infections (SSI) Reports for the following procedures, in all hospitals where these procedures are performed. 

Thoracic Surgical Procedures: (each contains one Table for all hospitals performing these procedures)

Orthopedic Surgical Procedures: (each contains one Table divided into three geographic regions)

Abdominal Surgical Procedures:  (each contains one Table divided into three geographic regions)

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Introduction: Central Line Associated Bloodstream Infections (CLABSI)

When a patient gets a bloodstream infection after having a central line put in (or, in the case of a newborn, an umbilical catheter) it’s considered a CLABSI.   A central line is an intravascular catheter (tube in a vein) that ends at or close to the heart or in one of the great vessels. An example of a great vessel is the aorta or superior vena cava. A central line can be used to infuse fluids or withdraw blood in patients. Central lines can be either temporary or permanent.

According to the CDC, an estimated 248,000 bloodstream infections occur in U.S. hospitals each year and many are CLABSIs. These bloodstream infections often lead to longer hospital stays, higher costs, and an increased risk of dying.  CLABSIs can often be prevented through proper insertion and care of the central line.

DHEC requires hospitals to report CLABSIs in selected patient units defined as NHSN  “Locations”. For these reports, the locations are combined by categories such as Critical Care and Inpatient Wards listed in the report tables below.  To calculate the infection rates, hospitals must also report the total number of “central line days” in each location for the reporting period.    

CLABSI Comparison reports will include only those locations with a pooled mean in the most recent NHSN Data Report.

CLABSI Reporting Changes: All hospitals report CLABSI data on the following units:

Adult Critical Care
Pediatric Critical Care
Inpatient Adult Wards
Inpatient Pediatric Wards
Inpatient Rehabilitation Units *
Long Term Acute Care Units **
Hematology/Oncology Units
Bone Marrow Transplant Units
Pediatric Hematology/Oncology Units

*Current CLABSI SIR data are not available for hospitals enrolled as inpatient rehabilitation facilities in the National Healthcare Safety Network (NHSN). The CDC has yet to release updated national benchmark data for this type of facility.  Data is available for inpatient rehabilitation units located within hospitals enrolled as acute care facilities within NHSN.

**Current CLABSI SIR data not available for hospitals enrolled as long term acute care facilities in the NHSN. The CDC has yet to release updated national benchmark data for this type of facility. Data is available for long term acute care units located within hospitals enrolled as acute care facilities within NHSN.

The CLABSI Summary Report provides the percentage of the microorganisms found in the blood cultures.  

Reports: Central Line Associated Bloodstream Infections (CLABSI) Locations:

Inpatient critical care units, also known as intensive care units- ICUs:

Selected CLABSI Summary Report: 

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Report: Methicillin resistant Staphylococcus aureus (MRSA) bloodstream infections:

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U.S. Hospital Compare (Dept. of Health and Human Services)

Hospital Compare

This website provides information on patient quality, including prevention and care of surgical site infections.  "Hospital Compare" was developed by the Centers for Medicare and Medicaid Services (CMS), an agency under the U.S. Department of Health and Human Services, and the Hospital Quality Alliance (HQA). "Hospital Compare" shows measures based on data from hospitals' patient records. The data is converted to reports that measure how well hospitals care for their patients.   Follow the instructions on the web site to locate specific hospitals in South Carolina.

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