Table 1a. Characteristics of facilities reporting to NHSN by State 1, 2010: Central Line-associated Bloodstream Infections (CLABSI)2
State | No. of Facilities in State 3 |
2009 | 2010 | ||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
No. of Facilities Covered by Mandate4 |
Any Validation5 |
Healthcare Facilities Reporting to NHSN | No. of Facilities Covered by Mandate4 |
Any Validation5 |
Healthcare Facilities Reporting to NHSN | ||||||||||||||
No. | %6 | Data Submission %7 |
Locations (n)2 | No. | % 6 | Data Submission %7 |
Locations (n)2 | ||||||||||||
Total | ICU | Wards2 | NICU8 | Total | ICU | Wards2 | NICU2 | ||||||||||||
Alabama | 122 | 0 | 1-4 | <10.0 | 67.3 | 27 | 12 | 11 | 4 | 0 | 69 | 56.6 | 45.8 | 157 | 112 | 38 | 7 | ||
Alaska | 29 | 0 | 1-4 | <10.0 | 55.6 | 3 | 2 | 0 | 1 | 0 | 1-4 | <20.0 | 81.3 | 4 | 3 | 0 | 1 | ||
Arizona | 105 | 0 | 1-4 | <10.0 | 100.0 | 4 | 4 | 0 | 0 | 0 | 24 | 22.9 | 63.7 | 53 | 42 | 10 | 1 | ||
Arkansas | 105 | 0 | 6 | 5.7 | 59.6 | 20 | 12 | 7 | 1 | 0 | 22 | 21.0 | 52.2 | 42 | 29 | 9 | 4 | ||
California | 383 | 0 | 139 | 36.3 | 73.1 | 461 | 220 | 206 | 35 | M | 367 | 95.8 | 74.0 | 2,239 | 546 | 1,567 | 126 | ||
Colorado | 100 | 59 | Yes | 60 | 60.0 | 91.4 | 97 | 63 | 17 | 17 | 58 | Yesa | 60 | 60.0 | 82.2 | 10 | 64 | 26 | 17 |
Connecticut | 42 | 30 | Yesa | 30 | 71.4 | 97.9 | 39 | 38 | 0 | 1 | 30 | Yesa | 30 | 71.4 | 91.5 | 41 | 38 | 0 | 3 |
Delaware | 14 | 8 | Yes | 8 | 57.1 | 79.6 | 18 | 13 | 3 | 2 | 8 | Yes | 8 | 57.1 | 85.5 | 19 | 13 | 4 | 2 |
D.C. | 16 | 0 | 1-4 | <30.0 | 90.6 | 8 | 8 | 0 | 0 | M | Yes | 11 | 68.8 | 42.6 | 36 | 24 | 7 | 5 | |
Florida | 213 | 0 | 21 | 9.9 | 75.1 | 57 | 37 | 15 | 5 | 0 | Yes | 51 | 23.9 | 53.2 | 168 | 81 | 78 | 9 | |
Georgia | 172 | 0 | 16 | 9.3 | 78.4 | 69 | 40 | 23 | 6 | 0 | 37 | 21.5 | 67.4 | 154 | 67 | 76 | 11 | ||
Hawaii | 28 | 0 | 1-4 | <10.0 | 75.0 | 1 | 1 | 0 | 0 | 0 | 7 | 25.0 | 45.1 | 12 | 6 | 6 | 0 | ||
Idaho | 52 | 0 | 1-4 | <10.0 | 100.0 | 1 | 1 | 0 | 0 | 0 | 1-4 | <10.0 | 40.3 | 6 | 2 | 3 | 1 | ||
Illinois | 215 | 150 | Yes | 148 | 68.8 | 80.2 | 325 | 228 | 66 | 31 | 149 | Yesa | 148 | 68.8 | 87.4 | 349 | 227 | 84 | 38 |
Indiana | 147 | 0 | 1-4 | <10.0 | 75.5 | 18 | 9 | 7 | 2 | 0 | 34 | 23.1 | 51.1 | 95 | 48 | 41 | 6 | ||
Iowa | 121 | 0 | 1-4 | <10.0 | 70.2 | 7 | 5 | 2 | 0 | 0 | 25 | 20.7 | 40.4 | 39 | 28 | 9 | 2 | ||
Kansas | 156 | 0 | 7 | 4.5 | 79.3 | 25 | 17 | 6 | 2 | 0 | 17 | 10.9 | 70.3 | 41 | 25 | 13 | 3 | ||
Kentucky | 124 | 0 | 13 | 10.5 | 75.8 | 54 | 34 | 17 | 3 | 0 | 21 | 16.9 | 70.3 | 67 | 45 | 18 | 4 | ||
Louisiana | 228* | 0 | 10 | 4.4 | 85.0 | 56 | 19 | 32 | 5 | 0 | 31 | 13.6 | 52.5 | 93 | 43 | 40 | 10 | ||
Maine | 36 | 0 | 1-4 | <20.0 | 79.6 | 27 | 10 | 16 | 1 | 0 | 7 | 19.4 | 76.9 | 30 | 12 | 17 | 1 | ||
Maryland | 70 | 45 | Yesa | 48 | 68.6 | 97.1 | 114 | 83 | 15 | 16 | 45 | Yesa | 47 | 67.1 | 81.1 | 143 | 85 | 41 | 17 |
Massachusetts | 111* | 73 | Yesa | 72 | 64.9 | 93.6 | 157 | 129 | 18 | 10 | 73 | Yesa | 71 | 64.0 | 95.1 | 151 | 123 | 18 | 10 |
Michigan | 190 | 0 | 32 | 16.8 | 80.4 | 102 | 72 | 23 | 7 | 0 | 52 | 27.4 | 67.6 | 159 | 100 | 50 | 9 | ||
Minnesota | 141 | 0 | 1-4 | <10.0 | 43.8 | 4 | 4 | 0 | 0 | 0 | 1-4 | <10.0 | 61.9 | 7 | 6 | 1 | 0 | ||
Mississippi | 106 | 0 | 6 | 5.7 | 89.7 | 47 | 17 | 28 | 2 | 0 | 16 | 15.1 | 76.5 | 78 | 27 | 45 | 6 | ||
Missouri | 156 | 0 | 8 | 5.1 | 90.6 | 16 | 12 | 2 | 2 | 0 | 13 | 8.3 | 90.5 | 28 | 18 | 6 | 4 | ||
Montana | 61 | 0 | 5 | 8.2 | 92.9 | 7 | 5 | 1 | 1 | 0 | 10 | 16.4 | 73.1 | 30 | 11 | 16 | 3 | ||
Nebraska | 92 | 0 | 1-4 | <10.0 | 95.8 | 20 | 5 | 14 | 1 | 0 | 10 | 10.9 | 66.2 | 35 | 11 | 22 | 2 | ||
Nevada | 59 | 0 | 1-4 | <10.0 | 63.5 | 8 | 6 | 1 | 1 | M | 23 | 39.0 | 36.4 | 69 | 33 | 33 | 3 | ||
New Hampshire | 26 | 25 | Yesa | 25 | 96.2 | 83.3 | 28 | 26 | 2 | 0 | 25 | Yesa | 24 | 92.3 | 86.3 | 31 | 26 | 5 | 0 |
New Jersey | 111 | 72 | Yes | 72 | 64.9 | 96.6 | 160 | 136 | 4 | 20 | 72 | Yesa | 72 | 64.9 | 96.4 | 159 | 136 | 3 | 20 |
New Mexico | 56 | 0 | 7 | 12.5 | 98.1 | 13 | 11 | 1 | 1 | 0 | Yesa | 18 | 32.1 | 57.0 | 49 | 24 | 23 | 2 | |
New York | 183 | 173 | Yesa | 183 | 100.0 | 94.1 | 475 | 377 | 44 | 54 | 182 | Yesa | 180 | 99.5 | 92.3 | 590 | 365 | 17 | 54 |
North Carolina | 124 | 0 | 24 | 19.4 | 77.1 | 110 | 49 | 56 | 5 | 0 | Yesa | 39 | 31.4 | 67.5 | 163 | 79 | 76 | 8 | |
North Dakota | 50 | 0 | 1-4 | <10.0 | 72.2 | 3 | 2 | 0 | 1 | 0 | 1-4 | <10.0 | 68.8 | 8 | 3 | 4 | 1 | ||
Ohio | 240 | 0 | 20 | 8.3 | 74.2 | 88 | 36 | 43 | 9 | 0 | 32 | 13.3 | 74.1 | 115 | 59 | 47 | 9 | ||
Oklahoma | 149 | 51 | 51 | 34.2 | 82.8 | 76 | 68 | 7 | 1 | 51 | 51 | 34.2 | 90.5 | 107 | 70 | 34 | 3 | ||
Oregon | 66 | 44 | Yesa | 47 | 71.2 | 84.1 | 73 | 58 | 14 | 1 | 42 | Yes | 48 | 72.7 | 82.4 | 79 | 59 | 19 | 1 |
Pennsylvania | 251 | 251 | Yesa | 235 | 93.6 | 83.5 | 1,616 | 326 | 1,246 | 44 | 215 | Yesa | 226 | 90.0 | 83.5 | 1,586 | 317 | 1,223 | 46 |
Puerto Rico | 65 | 0 | 0 | 0 | . | . | . | . | . | 0 | 0 | 0 | . | . | . | . | . | ||
Rhode Island | 16 | 0 | 1-4 | <10.0 | 58.3 | 1 | 1 | 0 | 0 | 0 | 1-4 | <30.0 | 38.6 | 11 | 6 | 4 | 1 | ||
South Carolina | 79 | 79 | Yesa | 72 | 91.1 | 58.1 | 433 | 106 | 324 | 3 | 79 | Yesa | 74 | 93.7 | 88.0 | 425 | 101 | 323 | 1 |
South Dakota | 65* | 0 | 0 | 0 | . | . | . | . | . | 0 | 1-4 | <10.0 | 38.9 | 3 | 2 | 1 | 0 | ||
Tennessee | 148 | 71 | Yesa | 78 | 52.7 | 92.4 | 192 | 149 | 17 | 26 | 80 | Yesa | 91 | 61.5 | 77.9 | 306 | 168 | 111 | 27 |
Texas | 641 | 0 | 16 | 2.5 | 69.2 | 50 | 39 | 5 | 6 | 0 | 83 | 12.9 | 44.4 | 204 | 131 | 55 | 18 | ||
Utah | 45 | 0 | 1-4 | <10.0 | 8.3 | 1 | 1 | 0 | 0 | 0 | 1-4 | <10.0 | 13.9 | 3 | 2 | 1 | 0 | ||
Vermont | 13 | 8 | 8 | 61.5 | 95.5 | 11 | 10 | 0 | 1 | 8 | 8 | 61.5 | 94.2 | 10 | 10 | 0 | 0 | ||
Virginia | 81 | 77 | Yes | 78 | 96.3 | 91.7 | 143 | 130 | 7 | 6 | 77 | Yesa | 81 | 100.0 | 84.9 | 203 | 136 | 60 | 7 |
Washington | 106* | 62 | Yesa | 64 | 58.5 | 89.3 | 112 | 81 | 15 | 16 | 62 | Yesa | 66 | 62.3 | 92.8 | 116 | 81 | 19 | 16 |
West Virginia | 64 | M | Yes | 38 | 59.4 | 60.7 | 73 | 55 | 18 | 0 | 36 | Yes | 38 | 59.4 | 68.0 | 105 | 55 | 49 | 1 |
Wisconsin | 137 | 0 | 13 | 9.5 | 81.2 | 43 | 21 | 17 | 5 | 0 | Yesa | 42 | 30.7 | 54.5 | 179 | 61 | 109 | 9 | |
Wyoming | 29 | 0 | 0 | 0 | . | . | . | . | . | 0 | 0 | 0 | . | . | . | . | . | ||
All- U.S. | 6,139 | 1,695 | 27.6 | 82.0 | 5,493 | 2,788 | 2,350 | 355 | 2,403 | 39.1 | 76.4 | 8,904 | 3,760 | 4,615 | 529 |
Footnotes for Tables 1a, 1b and 1c:
- United States, Washington, D.C., and Puerto Rico.
- Data included in this report are from 2009 (CLABSI, SSI) and 2010 (CLABSI, SSI, CAUTI) from acute care facility ICUs (critical care units), NICUs (see 9), and wards (for this report wards also include stepdown, specialty care areas [including hematology/oncology, bone marrow transplant], LTAC locations [or facilities]). Long–term care facilities (skilled nursing facilities) and dialysis locations are not included in this report.
- The number of acute care facilities reported to CDC by the state health department. Where indicated by a “*,” this number was taken from the 2009 American Hospital Association survey of healthcare facilities and acknowledged by the state.
- The number of acute care facilities eligible to report the HAI type under a mandate; for states in which a mandate exists to report that HAI type to the state health department using NHSN at the beginning of each reporting period. This number is reported to CDC by the state health department. If no mandate existed at the beginning of a reporting period, this number is zero. If no mandate existed at the beginning of a reporting period, but was implemented during the reporting period, the value of this column is “M” for midyear implementation. These values are presumed to be constant over sequential reporting periods unless update provided by state health department. Since mandates regarding surgical procedures vary greatly in type of procedure, the presence or absence of a mandate involving any surgical procedure for acute care facilities is indicated by Yes/No.
- Yes indicates that the state health department reported the completion of any of the following validation studies of NHSN data reported during the reporting period: data quality assessment of missing or implausible values and/or detection of outlier facilities (e.g., number of infections, rates, denominators). Yesa indicates that the state completed one or both of these activities and also conducted an audit of medical records. Information on validation efforts was requested from all states, regardless of presence of a legislative mandate for the particular HAI type. Some states without mandatory reporting of a given HAI have performed validation on NHSN data that is voluntarily shared with them by facilities.
- This measure is calculated using multiple data sets. It is calculated by dividing “No. of Healthcare Facilities Reporting” by “No. of Healthcare Facilities,” and multiplying by 100. The denominator comes from either the state health department’s self-reported data, or the 2009 AHA dataset. The numerator comes from the NHSN system, and includes all facilities for which data were reported for at least one month during the 12 month reporting period. For CLABSI, this does not include facilities for which zero central line-days were reported for all 12 months; for CAUTI this does not include facilities for which zero urinary catheter-days were reported for all 12 months; for SSI, this does not include facilities for which zero of the selected procedure types were performed for all 12 months. In states for which the AHA count is acknowledged by the state as the best estimate of number of healthcare facilities, this percentage assumes that all NHSN facilities are included in the AHA facilities count; that is, that the NHSN facilities are a subset of the AHA facilities. However, the AHA data do not necessarily comprise the total pool of facilities eligible to participate in NHSN. There are some AHA facilities that are not participating in NHSN; also, there are some facilities within the NHSN system that are not included in the AHA list. In states with a mandate to report HAI data using NHSN, some facilities in the number provided by the state health department (or in the AHA number) might not be included in mandate (e.g., facilities do not have the units or perform the procedures covered by the mandate; or the mandate covers only facilities above a certain bed size); or, some facilities included in the mandate might have reported zero central line-days, zero urinary catheter-days, or zero of the procedure types performed, for the full 12-month period.
- This metric is the rate at which facilities submitted data to NHSN during the reporting period. It is calculated by dividing the number of months of data submitted to NHSN by the total number of months of data eligible to be submitted, and multiplying by 100. For CLABSI or CAUTI, a month in which zero device days were reported is not counted in the numerator; for SSI, a month in which zero of the procedure types were performed is not counted in the numerator. For SSI, this is calculated by dividing the number of months that at least 1 procedure was reported to NHSN by the total number of months any procedure could have been reported, multiplied by 100. For example, if a state has two facilities reporting to NHSN, then 24 total months of data could have been submitted to NHSN in a 12-month period. If those two facilities sent in 24 total months of data, the state participation percent is 100%. If one facility submitted data for 8 months and the other for 4 months, then the state participation percent is 50% (data were reported for 12 of 24 total months). For states with a mandate, it is possible for this percentage to be <100 for several reasons, including that some facilities reporting might not be covered by the mandate, might only be submitting selected months of data, or might not have had any central line-days, urinary catheter-days or performed any procedures in a given month to report.
- NICU locations included are those classified by NHSN CDC location codes as Level II/III and Level III neonatal critical care areas. A Level II/III neonatal critical care area is defined by NHSN as: combined nursery housing both Level II and III newborns and infants. A Level III neonatal critical care area is defined by NHSN as: a hospital NICU organized with personnel and equipment to provide continuous life support and comprehensive care for extremely high-risk newborn infants and those with complex and critical illness. Level III is subdivided into four levels differentiated by the capability to provide advanced medical and surgical care.
- SSIs included are those following select surgical procedures approximating procedures covered by SCIP, using NHSN-defined SSIs that were classified as deep incisional or organ/space, and were detected during admission or upon readmission. The SCIP procedures are listed in Appendix A.