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Infection Control - Adults


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"). Many of the other sections of this report also have infection control indicators. Norton Healthcare performance represents the performance of all the hospitals combined.

Med-Surg ICUs - infections per 1000 device days (NHSN)
Number of medical/surgical intensive care unit (ICU) patients who acquired a catheter-associated urinary tract infection (UTI) in the ICU (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 adult inpatients with patient days in a medical/surgical intensive care unit who had a urinary catheter. Excludes patients in the adult cardiothoracic intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with a urinary tract infection present or incubating at admission.(NQF HC 17 / NQF Nurs 6a / NHSN) cath-assoc. UTIs low 1.7 2.8 1.8 1.0   1.9   1.4
Number of medical/surgical intensive care unit (ICU) patients who acquired a central-line-associated blood stream infection (BSI) in the ICU (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 adult inpatients with patient days in a medical/surgical intensive care unit who had a central line. Excludes patients in the adult cardiothoracic intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with a bloodstream infection incubating or present at admission.(NQF HC 18 / NQF Nurs 7a / NHSN) central-line-assoc. BSIs low 2.5 1.9 1.8 0.5   1.8   0.9
Number of medical/surgical intensive care unit (ICU) patients who acquired a ventilator associated condition in the ICU (per 1000 ventilator days). . Pneumonia, especially following a period of mechanical ventilation, is the second most common infection in ICUs. Pneumonia can lead to increased risk of mortality and prolonged hospital stays. Includes adult inpatients with patient days in a medical/surgical intensive care unit who were on a ventilator. Excludes patients in the adult cardiothoracic intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with pneumonia incubating or present at admission. Ventilator associated condition low 4.8 3.1 3.9 8.1   4.4    
Number of medical/surgical intensive care unit (ICU) patients who acquired a infection related ventilator associated complication in the ICU (per 1000 ventilator days). . Pneumonia, especially following a period of mechanical ventilation, is the second most common infection in ICUs. Pneumonia can lead to increased risk of mortality and prolonged hospital stays. Includes adult inpatients with patient days in a medical/surgical intensive care unit who were on a ventilator. Excludes patients in the adult cardiothoracic intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with pneumonia incubating or present at admission. Infection related ventilator associated complication low 1.1 1.2 3.4 2.3   2.3    
Number of medical/surgical intensive care unit (ICU) patients who acquired a possible ventilator associated pneumonia in the ICU (per 1000 ventilator days). . Pneumonia, especially following a period of mechanical ventilation, is the second most common infection in ICUs. Pneumonia can lead to increased risk of mortality and prolonged hospital stays. Includes adult inpatients with patient days in a medical/surgical intensive care unit who were on a ventilator. Excludes patients in the adult cardiothoracic intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with pneumonia incubating or present at admission. Possible ventilator associated pneumonia low 1.6 0Quality Ribbon 1.1 0Quality Ribbon   0.9    
Number of medical/surgical intensive care unit (ICU) patients who acquired a probable ventilator associated pneumonia in the ICU (per 1000 ventilator days). . Pneumonia, especially following a period of mechanical ventilation, is the second most common infection in ICUs. Pneumonia can lead to increased risk of mortality and prolonged hospital stays. Includes adult inpatients with patient days in a medical/surgical intensive care unit who were on a ventilator. Excludes patients in the adult cardiothoracic intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with pneumonia incubating or present at admission. Probable ventilator associated pneumonia low 0Quality Ribbon 0Quality Ribbon 0.3 1.2   0.3    
Cardiothoracic ICUs - infections per 1000 device days (NHSN)
Number of cardiothoracic (heart and chest) intensive care unit (ICU) patients who acquired a catheter-associated urinary tract infection (UTI) in the ICU (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 adult inpatients with patient days in a cardiothoracic intensive care unit who had a urinary catheter. Excludes patients in the adult medical/surgical intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with a urinary tract infection present or incubating at admission.(NQF HC 17 / NQF Nurs 6b / NHSN) cath-assoc. UTIs low 1.9   2.7     2.2   1.8
Number of cardiothoracic (heart and chest) intensive care unit (ICU) patients who acquired a central line catheter-associated blood stream infection (BSI) in the ICU (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 adult inpatients with patient days in a cardiothoracic intensive care unit who had a central line. Excludes patients in the adult medical/surgical intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with a bloodstream infection incubating or present at admission.(NQF HC 18 / NQF Nurs 7b / NHSN) central-line-assoc. BSIs low 1.0   1.7     1.3   0.8
Number of medical/surgical intensive care unit (ICU) patients who acquired a ventilator associated condition in the ICU (per 1000 ventilator days). . Pneumonia, especially following a period of mechanical ventilation, is the second most common infection in ICUs. Pneumonia can lead to increased risk of mortality and prolonged hospital stays. Includes adult inpatients with patient days in a cardiothoracic intensive care unit who were on a ventilator. Excludes patients in the adult medical/surgical intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with pneumonia incubating or present at admission. Ventilator associated condition low 6.2   3.0     4.7    
Number of medical/surgical intensive care unit (ICU) patients who acquired a infection related ventilator associated complication in the ICU (per 1000 ventilator days). . Pneumonia, especially following a period of mechanical ventilation, is the second most common infection in ICUs. Pneumonia can lead to increased risk of mortality and prolonged hospital stays. Includes adult inpatients with patient days in a cardiothoracic intensive care unit who were on a ventilator. Excludes patients in the adult medical/surgical intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with pneumonia incubating or present at admission. Infection related ventilator associated complication low 0.6   0.7     0.7    
Number of medical/surgical intensive care unit (ICU) patients who acquired a possible ventilator associated pneumonia in the ICU (per 1000 ventilator days). . Pneumonia, especially following a period of mechanical ventilation, is the second most common infection in ICUs. Pneumonia can lead to increased risk of mortality and prolonged hospital stays. Includes adult inpatients with patient days in a cardiothoracic intensive care unit who were on a ventilator. Excludes patients in the adult medical/surgical intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with pneumonia incubating or present at admission. Possible ventilator associated pneumonia low 0Quality Ribbon   3.0     1.4    
Number of medical/surgical intensive care unit (ICU) patients who acquired a probable ventilator associated pneumonia in the ICU (per 1000 ventilator days). . Pneumonia, especially following a period of mechanical ventilation, is the second most common infection in ICUs. Pneumonia can lead to increased risk of mortality and prolonged hospital stays. Includes adult inpatients with patient days in a cardiothoracic intensive care unit who were on a ventilator. Excludes patients in the adult medical/surgical intensive care unit, pediatric intensive care unit, neonatal intensive care unit and patients with pneumonia incubating or present at admission. Probable ventilator associated pneumonia low 0Quality Ribbon   0.7     0.3    
Miscellaneous (AHRQ)
Number of medical and surgical patients per 100 who developed a blood stream infection due to central venous catheters. Risk-adjusted for age, sex, DRG, and comorbidity categories. Includes medical and surgical discharges defined by specific DRGs. Excludes patients with a central venous catheter infection as a principal diagnosis or secondary diagnosis present on admission, hospitalizations less than 2 days, and patients with a diagnosis of immunocompromised state or cancer.(AHRQ PSI 7) % inpatients w/ central venous-catheter related BSI low 0.05 0.04 0.08 0.03   0.06   0.04
Med-Surg ICUs - 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 1.04 2.36 0.75 0.6   0.98   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 2.75 2.15 1.52 0.59   1.73   1
Cardiothoracic ICUs - 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 1.04   1.48     1.22   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 1.24   2.08     1.61   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 Adult low 2.62 2.13 1.31 1.35   1.95   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 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 hysterectomy Adult low # 2.26 0Quality Ribbon 0.91   0.85   1


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

Med-Surg ICUs - 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 0.78 0.70 0.75 0.62   0.73   0.64
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 0.60 0.46 0.69 0.56   0.60   0.48
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. Ventilator associated condition low 0.35 0.36 0.34 0.28   0.34    
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. Infection related ventilator associated complication low 0.35 0.36 0.34 0.28   0.34    
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. Possible ventilator associated pneumonia low 0.35 0.36 0.34 0.28   0.34    
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. Probable ventilator associated pneumonia low 0.35 0.36 0.34 0.28   0.34    
Cardiothoracic ICUs - 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 0.78   0.77     0.78   0.66
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 0.64   0.71     0.67   0.67
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. Ventilator associated condition low 0.34   0.39     0.36    
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. Infection related ventilator associated complication low 0.34   0.39     0.36    
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. Possible ventilator associated pneumonia low 0.34   0.39     0.36    
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. Probable ventilator associated pneumonia low 0.34   0.39     0.36    


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

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