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Children - Infection Control


Infection control refers to activities performed to reduce the risk of infections. Although infection control is a long-standing activity for hospitals, it does not have well-established comparative indicators. We follow CDC (Centers for Disease Control and Prevention) guidelines for the identification and public reporting of infections. Like other hospitals, we practice universal precautions to reduce infections, but we collect systematic data only for selected infections ("targeted surveillance") that occur in the pediatric and neonatal intensive care units. Many of the other sections of this report also have infection control indicators. Norton Healthcare performance represents the performance of all the hospitals combined.

Neonatal ICU - infections per 1000 device days, by birthweight (NHSN)
Number of neonatal intensive care unit (NICU) patients with a birth weight of <=750 grams (1.7 lbs) who acquired a central line-associated blood stream infection (BSI) in the NICU (per 1000 central line or umbilical catheter days). Central line or umbilical catheter must have been in place at the time or within 48 hours prior to onset of symptoms for infection to be included in these numbers. BSI can lead to increased risk of mortality and prolonged ICU stays. Low birth weight is associated with increased infections in NICU patients. Includes inpatients with patient days in a neonatal intensive care unit who had a central line or umbilical catheter. Excludes patients in all adult intensive care units, pediatric intensive care unit and patients with a bloodstream infection present or incubating at admission. Risk-adjusted for birth weight.(NQF HC 18 / NQF Nurs 7d / NHSN) central-line-assoc. BSIs, <=750 g low       1.3 1.3 1.3   2.3
Number of neonatal intensive care unit (NICU) patients with a birth weight of 751-1000 grams (1.7 - 2.2 lbs) who acquired a central line-associated blood stream infection (BSI) in the NICU (per 1000 central line or umbilical catheter days). Central line or umbilical catheter must have been in place at the time or within 48 hours prior to onset of symptoms for infection to be included in these numbers. BSI can lead to increased risk of mortality and prolonged ICU stays. Low birth weight is associated with increased infections in NICU patients. Includes inpatients with patient days in a neonatal intensive care unit who had a central line or umbilical catheter. Excludes patients in all adult intensive care units, pediatric intensive care unit and patients with a bloodstream infection present or incubating at admission. Risk-adjusted for birth weight.(NQF HC 18 / NQF Nurs 7d / NHSN) central-line-assoc. BSIs, 751-1000 g low       2.6 2.6 2.6   1.6
Number of neonatal intensive care unit (NICU) patients with a birth weight of 1001-1500 grams (2.2 - 3.3 lbs) who acquired a central line-associated blood stream infection (BSI) in the NICU (per 1000 central line or umbilical catheter days). Central line or umbilical catheter must have been in place at the time or within 48 hours prior to onset of symptoms for infection to be included in these numbers. BSI can lead to increased risk of mortality and prolonged ICU stays. Low birth weight is associated with increased infections in NICU patients. Includes inpatients with patient days in a neonatal intensive care unit who had a central line or umbilical catheter. Excludes patients in all adult intensive care units, pediatric intensive care unit and patients with a bloodstream infection present or incubating at admission. Risk-adjusted for birth weight.(NQF HC 18 / NQF Nurs 7e / NHSN) central-line-assoc. BSIs, 1001-1500 g low       0.7 0.7 0.7   1.1
Number of neonatal intensive care unit (NICU) patients with a birth weight of 1501-2500 grams (3.3 - 5.5 lbs) who acquired a central line-associated blood stream infection (BSI) in the NICU (per 1000 central line or umbilical catheter days). Central line or umbilical catheter must have been in place at the time or within 48 hours prior to onset of symptoms for infection to be included in these numbers. BSI can lead to increased risk of mortality and prolonged ICU stays. Low birth weight is associated with increased infections in NICU patients. Includes inpatients with patient days in a neonatal intensive care unit who had a central line or umbilical catheter. Excludes patients in all adult intensive care units, pediatric intensive care unit and patients with a bloodstream infection present or incubating at admission. Risk-adjusted for birth weight.(NQF HC 18 / NQF Nurs 7f / NHSN) central-line-assoc. BSIs, 1501-2500 g low       0Quality Ribbon 0Quality Ribbon 0Quality Ribbon   0.6
Number of neonatal intensive care unit (NICU) patients with a birth weight of >2500 grams (5.5 lbs) who acquired a central line-associated blood stream infection (BSI) in the NICU (per 1000 central line or umbilical catheter days). Central line or umbilical catheter must have been in place at the time or within 48 hours prior to onset of symptoms for infection to be included in these numbers. BSI can lead to increased risk of mortality and prolonged ICU stays. Low birth weight is associated with increased infections in NICU patients. Includes inpatients with patient days in a neonatal intensive care unit who had a central line or umbilical catheter. Excludes patients in all adult intensive care units, pediatric intensive care unit and patients with a bloodstream infection present or incubating at admission. Risk-adjusted for birth weight.(NQF HC 18 / NQF Nurs 7g / NHSN) central-line-assoc. BSIs, 2500+ g low       1.5 1.5 1.5   0.8
Pediatric ICU - infections per 1000 device days (NHSN)
Number of pediatric intensive care unit (PICU) patients who acquired a catheter-associated urinary tract infection (UTI) in the PICU (per 1000 urinary catheter days). Catheter must have been in place at the time of or within 48 hours before onset of event for infection to meet the criteria. The urinary tract is the most common site of nosocomial (originating in the hospital) infections. UTI is defined using symptomatic urinary tract infection or Asymptomatic Bacteremic UTI criteria. Includes inpatients with patient days in a pediatric intensive care unit who had a urinary catheter. Excludes patients in all adult intensive care units, neonatal intensive care unit and patients with a urinary tract infection present or incubating at admission.(NQF HC 17 / NQF Nurs 6c / NHSN) cath-assoc. UTIs low         2.4 2.4   2.7
Number of pediatric intensive care unit (PICU) patients who acquired a central-line-associated blood stream infection (BSI) in the PICU (per 1000 central line days). Central line must have been in place at the time or within 48 hours prior to onset of symptoms for infection to be included in these numbers. BSI can lead to increased risk of mortality and prolonged ICU stays. Includes inpatients with patient days in a pediatric intensive care unit who had a central line catheter. Excludes patients in all adult intensive care units, neonatal intensive care unit and patients with a bloodstream infection present or incubating at admission.(NQF HC 18 / NQF Nurs 7c / NHSN) central-line-assoc. BSIs low         1.5 1.5   1.4
Number of pediatric intensive care unit (PICU) patients on a ventilator who acquired a ventilator-associated pneumonia in the PICU (per 1000 ventilator days). Ventilator must have been in place at the time or within 48 hours prior to onset of symptoms for infection to be included in these numbers. Pneumonia, especially following a period of mechanical ventilation, is the second most common infection in PICUs. Pneumonia can lead to increased risk of mortality and prolonged hospital stays. Includes inpatients with patient days in a pediatric intensive care unit who were on a ventilator. Excludes patients in all adult intensive care units, neonatal intensive care unit and patients with pneumonia present or incubating at admission.(NQF HC 19 / NQF Nurs 8c / NHSN) vent-assoc. pneumonia low         0Quality Ribbon 0Quality Ribbon   0.8
Pediatric Hematology/Oncology - infections per 1000 device days (NHSN)
Number of pediatric hematology / oncology unit (HEM/ONC) patients who acquired a central-line-associated blood stream infection (BSI) in the unit (per 1000 permanent central line days). Central line must have been in place at the time or within 48 hours prior to onset of symptoms for infection to be included in these numbers. BSI can lead to increased risk of mortality and prolonged length of stay. Includes inpatients with patient days in a pediatric specialty care area of hematology or oncology unit who had a permanent central line catheter. Excludes patients in all intensive care units and patients with a bloodstream infection present or incubating at admission.(NHSN) perm central-line-assoc. BSI low         2.8 2.8   1.7
Miscellaneous (AHRQ)
Number of newborns with a birth weight between 500 to 1499g, birth weight greater than 1500g with major surgery or transfer to an acute care facility, or gestational age between 24 and 30 weeks who developed a hospital-acquired blood stream infection. Excludes patients with a length of stay less than 2 days.(AHRQ NQI 03) % neonates w/ hospital acquired bloodstream infection low     # 0Quality Ribbon 0.62 0Quality Ribbon    
Neonatal ICU - Standardized Infection Ratio, by birthweight
Standardized infection Ratio (SIR) is the proportion of actual infections to expected infections. Actual infections = total number of infections by all patients in the selected population during the selected time period. Expected infections = total number of expected infections based on 2012 National rates during selected time period. Color coding is based on comparisons of the SIR to the NHSN 95th and 5th SIR percentile for similar unit types(NHSN) central line & umbilical cath combined, <=750 g low       0Quality Ribbon 0.6 0.55   1
Standardized infection Ratio (SIR) is the proportion of actual infections to expected infections. Actual infections = total number of infections by all patients in the selected population during the selected time period. Expected infections = total number of expected infections based on 2012 National rates during selected time period. Color coding is based on comparisons of the SIR to the NHSN 95th and 5th SIR percentile for similar unit types(NHSN) central line & umbilical cath combined, 751-1000 g low       2.39 1.4 1.62   1
Standardized infection Ratio (SIR) is the proportion of actual infections to expected infections. Actual infections = total number of infections by all patients in the selected population during the selected time period. Expected infections = total number of expected infections based on 2012 National rates during selected time period. Color coding is based on comparisons of the SIR to the NHSN 95th and 5th SIR percentile for similar unit types(NHSN) central line & umbilical cath combined, 1001-1500 g low       0Quality Ribbon 0.75 0.62   1
Standardized infection Ratio (SIR) is the proportion of actual infections to expected infections. Actual infections = total number of infections by all patients in the selected population during the selected time period. Expected infections = total number of expected infections based on 2012 National rates during selected time period. Color coding is based on comparisons of the SIR to the NHSN 95th and 5th SIR percentile for similar unit types(NHSN) central line & umbilical cath combined, 1501-2500 g low       0Quality Ribbon 0Quality Ribbon 0Quality Ribbon   1
Standardized infection Ratio (SIR) is the proportion of actual infections to expected infections. Actual infections = total number of infections by all patients in the selected population during the selected time period. Expected infections = total number of expected infections based on 2012 National rates during selected time period. Color coding is based on comparisons of the SIR to the NHSN 95th and 5th SIR percentile for similar unit types(NHSN) central line & umbilical cath combined, 2500+ g low       0Quality Ribbon 2 1.85   1
Pediatric ICU - Standardized Infection Ratio
Standardized infection Ratio (SIR) is the proportion of actual infections to expected infections. Actual infections = total number of infections by all patients in the selected population during the selected time period. Expected infections = total number of expected infections based on 2012 National rates during selected time period. Color coding is based on comparisons of the SIR to the NHSN 95th and 5th SIR percentile for similar unit types(NHSN) urinary catheter low         0.9 0.9   1
Standardized infection Ratio (SIR) is the proportion of actual infections to expected infections. Actual infections = total number of infections by all patients in the selected population during the selected time period. Expected infections = total number of expected infections based on 2012 National rates during selected time period. Color coding is based on comparisons of the SIR to the NHSN 95th and 5th SIR percentile for similar unit types(NHSN) central line low         1.09 1.09   1
Pediatric Hematology/Oncology - Standardized Infection Ratio
Standardized infection Ratio (SIR) is the proportion of actual infections to expected infections. Actual infections = total number of infections by all patients in the selected population during the selected time period. Expected infections = total number of expected infections based on 2012 National rates during selected time period. Color coding is based on comparisons of the SIR to the NHSN 95th and 5th SIR percentile for similar unit types(NHSN) permanent central line low         1.62 1.62   1
Colon and Abdominal Hysterectomy Surgery SSI - Standardized Infection Ratio
Standardized infection Ratio (SIR) is the proportion of actual infections to expected infections. Actual infections = total number of infections by all patients in the selected population during the selected time period. Expected infections = total number of expected infections based NHSN defined risk models. Color coding is based on comparisons of the SIR to the NHSN 95th and 5th SIR percentile.(NHSN) Surgical site infections for colon surgery Children low         0.54 0.54   1
Surgical site infections for hysterectomy Children low         # #   1


Standardized Infection Ratio = (# actual infections / # expected infections)

Neonatal ICU - device utilization ratio, by birthweight (these are not infection rates)
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) central line & umbilical cath combined, <=750 g low       0.32 0.31 0.31   0.41
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) central line & umbilical cath combined, 751-1000 g low       0.31 0.21 0.23   0.35
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) central line & umbilical cath combined, 1001-1500 g low       0.13 0.16 0.15   0.26
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) central line & umbilical cath combined, 1501-2500 g low       0.05 0.16 0.13   0.18
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) central line & umbilical cath combined, 2500+ g low       0.04 0.18 0.14   0.24
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) ventilator, <=750 g low       0.25 0.35 0.34   0.38
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) ventilator, 751-1000 g low       0.08 0.19 0.16   0.23
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) ventilator, 1001-1500 g low       0.02 0.08 0.06   0.10
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) ventilator, 1501-2500 g low       0.01 0.06 0.04   0.07
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) ventilator, 2500+ g low       0.01 0.11 0.07   0.11
Pediatric ICU - device utilization ratio (these are not infection rates)
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) urinary catheter low         0.20 0.20   0.21
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) central line low         0.49 0.49   0.46
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) ventilator low         0.04 0.04   0.37
Pediatric Hematology/Oncology - device utilization ratio (these are not infection rates)
Utilization ratio (UR) is the proportion of patient days for which a certain device is used. UR are specific to a certain device: urinary catheter, central line, or ventilator. Device-days = total number of days of exposure to the device (urinary catheter, central line, or ventilator) by all patients in the selected population during the selected time period Patient-days = total number of days that patients are in the surveillance unit during selected time period. Color coding is based on comparisons of the UR to the NHSN 75th and 25th UR percentile for similar unit types(NHSN) permanent central line low         0.82 0.82   0.62


Device Utilization = (# device days / # patient days)

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