About the National Healthcare Safety Network
The National Healthcare Safety Network (NHSN), which is a secure, internet-based surveillance system, is the primary tool used for collecting healthcare-associated infection (HAI) data from health care facilities in most U.S. states and territories. The HAI Program uses NHSN data to
estimate the burden of HAIs in Oregon and provides data to
measure the impact of Oregon surveillance and prevention programs.
Before HAI data is shared with the public, healthcare facilities review their data to ensure there are no data quality issues. Additionally, NHSN data is also reviewed by HAI program staff through a process called external validation.
Learn about NHSN
View the data
What is Validation
Internal Validation
Before sharing HAI data with the public, HAI program staff review all data submitted and provide each facility their annual HAI data to review. Facilities have time to respond and correct any errors. The HAI Program offers technical assistance to help resolve any data issues before data are published.
OHA's Internal Validation Guidance
External Validation
The HAI Program performs validation of healthcare facility data reported to NHSN to ensure accurate and complete reporting of Oregon HAI data. External validation allows us to:
- Monitor accuracy of data submitted to NHSN
- Assess healthcare facility surveillance systems and their use of NHSN definitions
- Ensure that healthcare facilities are reporting infections consistently
Which HAIs Have We Validated?
Dialysis Event Validation
Why is it important?
Nationwide, over 550,000 individuals with end-stage renal disease rely on hemodialysis. According to the CDC an estimated 14,000 dialysis-related bloodstream infections occurred in 2020, with an episode of infection costing up to $28,000.
Dialysis patients are at high risk of infection from pathogens that can spread from contaminated surfaces and hands to their bloodstream through dialysis access points. Keeping patients safe and improving care quality are big reasons why we closely monitor this data.
Addressing dialysis-related bloodstream infections is also important for achieving health equity. Bloodstream infections happen more often in Black and Hispanic patients, and in areas of the with higher poverty, more household crowding, and lower education levels (from U.S. census data.
What did we do?
The HAI Program conducted external validation in 14 Oregon outpatient hemodialysis facilities from August 2018 through March 2019. The HAI program reviewed the medical records of patients to check that facilities reported accurate data to NHSN and evaluated the facilities’ knowledge and practices around NHSN surveillance.
What has changed?
The results of this validation provided guidance to outpatient hemodialysis facility staff to assist with their surveillance, internal validation, and use of their NHSN data for action.
Central Line-Associated Bloodstream Infection (CLABSI) Infection
Why is it important?
A central line-associated bloodstream infection is a serious infection that occurs when bacteria enter the bloodstream through a central line. A central line is a catheter (tube) that healthcare providers place in a large vein in the neck, chest, or arm to provide fluids, blood, or medications.
Commonly found in an intensive care unit (ICU) setting, central lines are different from short-term intravenous catheter’s (IVs) because they terminate in major veins close to the heart. They can remain in place for weeks or even months and are much more likely to cause a serious infection.
CLABSIs result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system, yet these infections are preventable. According to the U.S. Centers for Disease Control and Prevention (CDC), an estimated 250,000 CLABSI cases occur each year in U.S. hospitals, resulting in 28,000 deaths. U.S. hospitals spend up to $2.68 billion annually to manage CLABSI cases.
What did we do?
The HAI Program conducted external validation of CLABSIs in 2009 (pdf) and 2012 (pdf) in Oregon hospitals. The HAI program reviewed the medical records of patients to check that facilities reported accurate data to NHSN and evaluated the facilities' knowledge and practices around NHSN surveillance.
What has changed?
The results of the validation (2009) (pdf) (2012) (pdf) were shared with facilities, additional CLABSIs were identified, and improvements were incorporated into the CDC 2012 CLABSI Validation Toolkit (pdf).
Surgical Site Infection Validation (SSI) Infection
Why is it important?
Surgical site infections are infections that occur after surgery in the part of the body where the surgery took place. Though SSIs can sometimes be superficial infections, involving only the skin, other times SSIs can be deeper and involve tissues beneath the skin in organs, or implanted material. Validation of SSI data is necessary to ensure accurate hospital reporting.
What did we do?
The HAI Program conducted a data validation study of SSIs occurring in patients hospitalized in Oregon for coronary artery bypass graft (CABG) procedures performed in 2009 and 2010. Staff reviewed the accuracy of data submitted by 14 hospitals that reported CABG SSI data during 2009 and 2010 to NHSN, assessed hospital surveillance systems, and evaluate the use of NHSN definitions. The validation occurred between September 2011 and June 2012.
What has changed?
The findings of this validation project provided guidance to hospital staff on their use of surveillance definitions and reporting methods and included recommendations for future validation studies.