Central-Line–Associated Bloodstream Infection Reporting Through the CDC National Healthcare Safety Network — Kansas, January 2011–June 2012

BACKGROUND:   Annually in the United States, 18,000 central-line–associated bloodstream infections (CLABSIs) occur in hospital intensive care units, with 12%–25% mortality and costing ~$25,000/event. In January 2011, voluntary CLABSI reporting was initiated in Kansas by using CDC’s Internet-based National Healthcare Safety Network (NHSN). Because CLABSI surveillance is new in Kansas, we evaluated its attributes.

METHODS:   We reviewed data for January 2011–June 2012 from participating acute-care hospitals (ACHs) with >25 beds to measure timeliness (proportion of events reported ≤30 days from month’s end) and data quality (data completeness and denominator reporting). In September 2012, we surveyed infection preventionists (IPs) from all Kansas hospitals to measure simplicity (data sources accessed to generate reportable data, understanding of NHSN CLABSI case definition, and IP training experience).

RESULTS:   During January 2011–June 2012, CLABSI was monitored in 93% (38/41) of ACHs; reporting timeliness increased from 50% to 89%. During January 2012–June 2012, completeness of CLABSI denominator reporting was 97%; required data regarding CLABSI reporting forms were 100% complete, whereas nonrequired data were 20%–40% complete. Eighty (59%) of 136 IPs responded to the survey; a median of 8 (range: 7–10) data sources were accessed monthly to report CLABSI. NHSN was used by 52 (65%) of 80 respondents; regarding understanding of CLABSI case definitions, 62% self-rated “good/excellent,” and 8% self-rated “somewhat/not at all.” Formal required on-line training to meet NHSN enrollment requirements was reported by 34 (65%) of 52 IPs.

CONCLUSIONS:   CLABSI reporting through NHSN is timely but complex. Our survey results indicate that additional IP training and CLABSI validation can help strengthen surveillance.