National Surveillance System for Health Care Workers (NaSH)
NaSH is a CDC surveillance system that focuses on exposures and infections among hospital-based health care workers. NaSH was developed by the Division of Health Care Quality Promotion, National Center for Infectious Diseases (NCID); the Division of Viral Hepatitis, NCID; the Division of Tuberculosis Elimination, National Center for HIV, STD, and TB Prevention; the National Immunization Program; and NIOSH. The objectives of NaSH are to monitor national trends and incidence rates of occupational infections among health care workers; identify newly emerging hazards for health care workers; assess the risk of occupational exposures and infections; and evaluate preventive measures including engineering controls, work practices, protective equipment, and post-exposure prophylaxis to prevent occupational infections.
NaSH enrollment is voluntary. To ensure that a representative sample of U.S. hospitals from every demographic category (including urban and rural, large and small, teaching and nonteaching, and serving minority and nonminority populations), the system has been advertised in several ways, including at scientific meetings of professional organizations and in their national newsletters. Hospitals participating in the CDC National Nosocomial Infection Surveillance System (NNIS) have also been invited to participate. Initial entry of a health care worker into NaSH usually occurs during the provision of health care at the hospital’s employee health service for a relevant event (e.g., routine tuberculin skin test, initial assessment or follow-up after an exposure to blood, or initial assessment or follow-up after an exposure to a vaccine-preventable disease).
Data are collected in NaSH to assist hospitals, health care workers, health care organizations, and public health agencies. Hospitals participating in this system benefit by receiving technical support and standardized methodologies (including software) for conducting occupational health surveillance activities. NaSH software permits hospitals to analyze their own data in an integrated system and compare their data with aggregate data from all NaSH hospitals.
The system collects the following data on health care workers: demographic information (identifying data is not sent to CDC), occupation, vaccination history, serologic results/immune status for vaccine-preventable diseases (including hepatitis B virus), tuberculin skin test results, evaluation for positive tuberculin skin tests and therapy status as appropriate, detailed information about the nature of the exposure to blood, body fluids and bloodborne pathogens, postexposure prophylaxis treatment, information about exposures and infections from vaccine-preventable diseases such as measles, and information about exposures to infectious TB. Hospitals provide CDC with denominator data (such as number of staff) once a year. Every 2 to 5 years, participating hospitals distribute a survey to employees (to be filled out anonymously) that asks about history of needlestick or sharps injuries; the purpose of this survey is to assess underreporting of incidents in the NaSH system.
For further information, contact
Health Care Outcomes Branch
Division of Health Care Quality Promotion
National Center for Infectious Diseases
Centers for Disease Control and Prevention
1600 Clifton Road, NE, MS–E55
Atlanta, GA 30333
Telephone: 800–893–0485
Nash@cdc.gov
www.cdc.gov/ncidod/hip/SURVEILL/nash.htm
