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Hospital Acquired Infections (HAIs) in South Carolina

HIDA Hospital Acquired Infections (HAI) Public Reports - 2008 Annual Report

To go directly to the Individual Hospital and Comparison Reports,
click on enlarged Report title in the list below:

 

 

 


Hospital Infections Disclosure Act (HIDA)
Hospital Acquired Infections Reports

Individual Hospital's HIDA HAI Reports
Individual Hospital Acquired Infections Report:  select on the name of the hospital as listed by hospital bed size category:

  • More than 500 beds (and teaching hospitals)
  • 201 to 500 beds
  • 51 to 200 beds
  • 50 beds or less.

    Each report contains the following information:
    • Alphabetical order by the hospital name within each hospital bed size category.
    • 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

HAI Compare Tables:

Hospitals are compared using the Standardized Infection Ratio (SIR) which is a summary measure used to compare the surgical site infection (SSI) and central line associated bloodstream infection experience among a group of reported procedures to that of a standard population. It is the observed number of infections divided by the expected (predicted) number of infections.  For HAI reports, the standard population comes from NHSN data reported from all hospitals using the system. Expected* means that when looking at the national average and the number of procedures that a hospital does, you would expect (or predict) a certain number of infections based on historical data for those procedures.

*Please note that the “expected” number of infections does not mean that you expect to get an infection when you go into the hospital. The goal is for the hospital is to prevent all preventable HAIs.

Each HAI Compare Table has the definition for Standardized Infection Ratio and Confidence Intervals, and additional information can be found in the Definition of Terms.  

Each Table contains 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
    • Too few procedures to report. Reporting on too few procedures is a risk to patient confidentiality. If five or fewer surgical procedures are performed, the report for the number of infections will be deferred until more procedures are performed.


HAI Compare - Tables for HIDA Reporting Requirements:
July 1, 2007 – November 30, 2008

Introduction:  Surgical Site Infections

Surgical site infections (SSI) are infections that are directly related to an operative procedure. For an infection to qualify as an SSI, there must be no evidence that it was present or incubating at the time of hospital admission. SSI rates are adjusted to take into account differences in patient risk factors for infection, such as length of the surgery, type of surgical wound and the patient's physical condition. Many SSIs can be prevented by following defined prevention methods. 

DHEC, with the advice of the HIDA Advisory Committee, selected the following surgical procedures (as they are defined in the National Healthcare Safety Network (NHSN) system) for mandatory public reporting: 

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

Hysterectomy (vaginal) is the removal of the uterus through vaginal or perineal incision.

Cholecystectomy & cholecystotomy are gallbladder surgeries. (Cholecystectomy is the removal of the gallbladder and cholecystotomy is the making of an opening into the gallbladder, usually to remove a stone.) 

Selected Summary Report: “SSI – the percentage of positive cultures with MRSA isolated”


Reports: Surgical Site Infections

Surgical Site Infections (SSI) reports are collected for the following procedures in all hospitals where these procedures are performed.  The orthopedic and abdominal procedure reports are divided into geographic regions to make them easier to compare because of the large number of procedures.

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

Orthopedic Surgical Procedures: (contains one report for each of the three geographic regions)

Abdominal Surgical Procedures:  (contains one report for each of the three geographic regions)

Selected: SSI Summary Report

 


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 200,000 CLABSIs occur in U.S. hospitals each year.  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 by NHSN  units or “Locations”. These locations are listed in the report tables below. Every time a patient gets an infection that meets the definition of a CLABSI in a specific reportable location, the hospitals must report it to the National Healthcare Safety Network (NHSN).  They must also report the total number of “central line days” in each location for the reporting period.    

Not every hospital will have all units. Hospitals decide which type of critical care unit (CCU), also known as ICUs, that they have, and they measure the type of patients that are cared for in that area and apply what is called the 80/20 rule. For instance, the medical ICU serves non-surgical patients, so if a hospital finds that 80 percent of their critical care patients are non-surgical that facility would have a medical ICU, according to NHSN definitions even though some surgical patients are cared for in that location. Hospital ICUs that handle 80 percent or more trauma patients are not required to submit a report for that ICU. The department is not reporting trauma information as patients in these areas have unique risk factors and complications are often less preventable. In addition, we have included a CLABSI report that summarizes the microorganisms found in the blood cultures. This report is for the following Reportable Locations:

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

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

Inpatient Wards

Selected CLABSI Summary Report: 


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.

 


Hospital Infection Prevention Processes Survey - 2009  (pending)

HIDA requires hospitals to report selected infection prevention processes to DHEC.  The combination of different infection prevention processes may vary by hospital. To assess current prevention practices, DHEC required hospitals to respond to an Infection Control/ Prevention Process Survey.  Summary results of the survey are presented here.