Proposed reporting requirement:

Central line-associated bloodstream infections:

This definition is insignificant to describe the appropriate patients to include. The statement “wards selected should be those with the longest length of stay during the previous calendar year, excluding cardiology, obstetrics, psychiatry, hospice, and step-down units”. Is this only to exclude these specific areas?  Collecting the denominator data for those lines outside of the ICU is very difficult and labor intensive.  I also wonder about the exclusion of the step-down unit.  This area as a step-down from the ICU would be a unit with greater numbers of central lines.

Clostridium difficile infection:

Not meaningful data. Without a computerized system there is data gathering and input. There is no way to know all prior locations to determine accurately if the patient has had a visit to a healthcare institution in the last three months. There is no clinical correlation to the lab testing.  There is no accounting for antibiotic history or any symptoms.  This is only a numbers collecting system and does not add value to clinical practice. This selection is less time consuming for the practitioner than the alternative NHSN C. diff reporting.  If c.diff as an indicator must be chosen the laboratory-identified events would be less time consuming but i am not sure of the value.  If the desire is just to have numbers of C.diff then just have a report the the VDH as a total number on a monthly basis.

Infection Preventionists are given more and more tasks for data collected from many agencies.  Most of the current time of the IP is spent in surveillance and little on prevention measures. CMS has instituted new requirements for CLABSI reporting. Virginia could have a greater impact with the reduction of HAI’s if they utilized their resources to evaluate the actual work of the IP and how to free up valuable time to prevention strategies.

Please consider more value added indicators for HAI reporting, Teresa