Akosua Adu MSc., DrPH Healthcare Associated Infection Prevention Program Division of Epidemiology and Health Planning Infection Prevention Boot Camp

Transcription

1 Akosua Adu MSc., DrPH Healthcare Associated Infection Prevention Program Division of Epidemiology and Health Planning Infection Prevention Boot Camp SEPTEMBER 28, 2017

2 OBJECTIVES Identify various tools provided by National Healthcare Safety Network (NHSN) to facilitate surveillance activities in healthcare settings. Focus on the types of data you can obtain from NHSN (rather than all of the technical steps to follow in the application). Utilize the various tools in meaningful clinical scenarios. 2

3 WHY ANALYZE? Helps facilitate internal validation activities and helps ensure accuracy Reports generated from NHSN can help inform prioritization and success of prevention activities Helps you know your data better Take ownership and discover how your data can tell a story about your facility 3

4 GENERATING DATASETS First step in performing analysis in NHSN Organizes data into defined sets for analysis and allows for quicker generation of reports When analyzing data in NHSN, you are using a copy of your data, not the live database: Copies and freezes data A new dataset can be generated by clicking Analysis Generate Data Sets > Generate New. 4

5 GENERATING DATASETS 5

6 ANALYSIS REPORTS After datasets are generated, you are ready to analyze your data in NHSN Click on Analysis Reports under the Analysis tab to see all available reports in NHSN The highlighted reports on the right are the most commonly used and basic report types 6

7 ANALYSIS OUTPUT OPTIONS Click on the folder for each module, to show you the event-level options within that folder. Each event-level folder can be expanded to show the various output options available for your use. Click Run next to any output option to obtain your data in a CDC-Defined output (report). 7

8 NHSN ANALYSIS OUTPUT OPTIONS Standard list of all report types: Line List Frequency Table Bar/Pie Chart Rate Table/Run Chart SIR Report Clicking Run will run a stock report using data for 2015 and forward Click Modify to create more specific reports 8

9 LINE LISTS Allows for record-level review of data Categorization of community-onset (CO) vs. healthcare facility-onset (HO) Can help inform rates or identify trends Most customizable type of output from NHSN 9

10 FREQUENCY TABLES Total counts of events Example: How many CAUTIs were reported as ABUTI? Can also perform chisquare analyses for statistical comparisons 10

11 BAR CHARTS & PIE CHARTS Visual depiction of counts of events (think of these as a graphical representation of the frequency table) Example: How many CLABSI events occurred in each ICU? NOTE: These options do not graphically present rates or standardized infection ratios. 11

12 RATE TABLES Monthly incidence and prevalence rates Display your facility s calculated rates and device-utilization ratios (where appropriate) Descriptions of rates can be found in the eventspecific chapters of the NHSN Manual 12

13 MODIFYING ANALYSIS REPORTS Analysis data source Type of report When data was generated Show Descriptive Variable Names Tip: For more descriptive variable labels on your report, check the box Show descriptive variable names (recommended). 13

14 MODIFYING ANALYSIS REPORTS Title/Format Used to modify the name and title of the report The Title is what will appear at the top of the generated report You may choose the format in which the report is displayed, such as HTML or PDF 14

15 MODIFYING ANALYSIS REPORTS Time Period Allows for selection of a specific time period for your report Select a date variable from the Date Variable drop down menu and specify the beginning and ending date for the desired time period If the Ending date is left blank, the results will include all data from the beginning time period and forward Specify by Date variable Beginning Ending Date eventdate 1/1/ /31/2015 Year evntdateyr Half-year evntdateyh 2015H1 2015H2 Quarter evntdateyq 2015Q1 2015Q2 Month evntdateym 01/ /

16 MODIFYING ANALYSIS REPORTS Filters Each addition of group and rule will allow you to specify values 16

17 MODIFYING ANALYSIS REPORTS Select a variable to filter Click in the empty box with the drop down arrow to select the operator (e.g., equal ) Specify desired values of that variable that should be included in the report 17

18 What s the difference between a Group and a Rule? A Group in this section refers to a set of Rules combined to make one filter. For example, if you wanted to generate a procedure line list for all COLO procedures in adult patients, OR all CRAN procedures regardless of age, you could set up two group filters, each with their own rules. An example of this is illustrated below: 18

19 MODIFYING ANALYSIS REPORTS Display Variables The Display Variables tab on the modification page is applicable to Line Lists and allows you to select which variables you would like to appear as columns in your report. To add a variable to the line list, select the variable in the Available Variables list and then click Selected > between the two columns. This will move the variable into the Selected Variables list. If you wish to add all of the variables to your line list, click All >>. To remove variables from your line list, select the variable in the Selected List and click the center < Selected button. You can use the up and down arrows to arrange the order of the variables in the report. Click Undo on the far right to undo any of the changes previously made to this tab. 19

20 MODIFYING ANALYSIS REPORTS Sort Variables Sort Variables tab is available only for Line Lists and allows you to sort whichever variable is ascending or descending order. You can sort by more than one variable. NOTE: the variable must be in your line list in order to sort on that variable. 20

21 MODIFYING ANALYSIS REPORTS Display options Allows you to view your report organized by a specific criteria For Line Lists: This is known as the Page By variable. For Rate Tables (SIRs and SAARs): This allow for the option to calculate and display results by time period e.g., by month, year, etc. 21

22 RUNNING A STANDARDIZED INFECTION RATIO (SIR) TABLE 22

23 SIR TABLE Report Modification: For the purpose of this example, the modifications that have been made are: summaryyr was set to

24 SIR TABLE Report Modification: filtered by Critical Care (CC) locationtype 24

25 SIR TABLE Report Modification: Report grouped by summaryyh. 25

26 SIR TABLE Output/Results SIR >1 = more HAIs were observed than predicted, based on the 2015 national aggregate data. p-value > 0.05 = the number of observed infections is not statistically significantly different than the number predicted. The C.I. includes the value of 1 = the SIR is not significantly different than 1 26

27 EXPORTING DATASETS Appears when you select your report type Exports the entire dataset from which the resulting report is generated Two options: Exports only data used in generating the report, for the specified time period and including selection criteria Exports Analysis Data Set 27

28 EXAMPLE Let s say you would like a list of all of the deviceassociated (DA) infections that your facility has reported to NHSN for the time period January June You would like one table per ICU location and you need the list sorted by event date. Additionally, you would like to include the specific event type reported for each infection. You also suspect that you will need this line list on more than one occasion, for different time periods, and would like to save this as a custom report 28

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30 CONCLUSION Develop a timeline to regularly enter, and analyze, your hospital s data Consider a timeline that would allow for timely feedback and interventions, if necessary Example: Monthly review of rates and event-level details Generate datasets regularly Read the footnotes on your reports!!! Review data for accuracy and completeness 30

31 REFERENCES Pictures courtesy of CDC dex.html